Progress 09/01/12 to 08/31/16
Outputs
Target Audience:The target audience for current project were Emergency Medical Services (EMS) providers in an11 county predominantly rural region of upstate New York(Clinton, Franklin, Essex, Washington, Warren, Schoharie, Fulton-Montgomery, Otsego, Oneonta, Delaware). The EMS training regions in which the study was focused are served by Mountain Lakes Regional EMS Council and the Adirondack-Appalachian Regional Emergency Medical Services (AAREMS), which serve the eastern Adirondacks and the Mohawk Valley respectively. The region is served by 190 EMS agencies, with approximately 2000 members, of which 78 agencies participated in the research study. The region covers an area of close to 10,000 square miles or roughly the size of the State of Vermont. The region covers the majority of the Adirondack Park and extend from Canada in the north to Pennsylvania in the south. Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?The research provided extensive training and professional development opportunities for the EMS providers in the region. 20 agencies received 1 simulation visit, 20 received 2 simulation visits, 19 received 3 or 4 simulation training visits. 19 agencies served as control sites and received traditional didactic training only. There were 638 unique individuals who attended research relatedtrainings. Training sessions consisted of 2 hours of Continuing Medical Education credit awardedper visit. A total of 82 seaparate sessions were held. The period of performance for the field operations portion of the research was from March 2013 to September 2014. How have the results been disseminated to communities of interest?Our SBIR results were submitted to the UCLA Prehospital Care Research Forum for presentation at the 2016 Annual Symposium of the National Association of EMS Educators (NAEMSE). HSS was selected as one of 12 poster presentations and one of only 4 oral presentations. On August 6th we presented our finding to over 400 educators at the NAEMSE conference in Fort Worth , Texas. https://www.facebook.com/PCRFatUCLA/ HSS will be submitting our research to the Prehospital Emergency Care journal for publication in the near future. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
From 2012 to 2016 Hudson Simulation Services (HSS), conducted a NIFA Phase IISmall Business Innovation Research (SBIR) Program to study the use of mobile medical simulation for training rural EMS providers in 11 Upstate New York counties. The NIOSH four stage Training Intervention Effectiveness Research (TIER) model was used as organizing framework. Phase II was conducted from September 2012 to August 2016. Seventy eight (78) agencies participated in Phase II. The participating agencies were selected at random from among 190 agencies to participate in Phase II. A demographic survey was sent to all 190 agencies to determine a recruitment and retention baseline. Training sessions consisted of 2 hours of continuing education instruction per visit. 20 agencies received 1 simulation visit, 20 received 2 simulation visits, 19 received 3 or 4 simulation training visits. 19 agencies served as control sites and received traditional didactic training only. The period of performance for the field operations was from March 2013 to September 2014. A total of 82 sessions were held and over 600 providers attended training sessions. Data was collected on knowledge, skills, attitudes, teamwork and membership changes between sessions. Training results were analyzed using t-test method . Topical knowledge, measured with 10 question pre-post quiz, increased more following the training at the simulation compared to the didactic sites (p=0.034). Simulation performances were video taped and scored by the instructors post-event. Simulation training significantly improved both clinical skills (p=0.004) and teamwork (p=0.008) between the first and last training. The increase was greater for the sites that received more sessions. Motivational scores were significantly higher among the simulation compared to the didactic participants (p=0.037). Average changes in membership size were highest for the sites which received the most simulation trainings and lowest for the sites which received only didactic trainings although this result was not statistically significant. We conclude that well executed EMS simulation can be more effective than didactic training alone. Simulation is appealing for adult learners. High yield applications, such as protocol rollouts or training on infrequently seen conditions offer strong return potential. Simulation may be able to assist with recruitment and retention as part of a comprehensive volunteer management strategy. The product development and commercialization plan adopted by HSS during our Phase II SBIR was designed to address barriers that exist to a more widespread adoption of medical simulation technology by healthcare educators. Our commercial goal with this project was to develop products and services that can be used by non-experts on a budget and still achieve high quality training results. The two products we proposed and did develop are: 1) a low-cost mobile Ambulance Simulator and a 2) a turnkey EMS Simulation Curriculum with online support which will allow non- simulation experienced faculty to deliver high quality learning. This initial vision has now been developed and recently released to the market with strong initial results. Sales to date of SBIR derived products and services exceed $400,000. HSS is currently working on opportunities that will potentially generate over $2m/ annually beginning in 2017. We believe that HSS is making a significant contribution to improving healthcare education through the NIFA SBIR program by reducing the cost and complexity of an important training technology.
Publications
- Type:
Conference Papers and Presentations
Status:
Published
Year Published:
2016
Citation:
Oral and Poster Presentation at National Association of EMS Educators by Hudson Simulation Services, Fort Worth, August 6th, 2016, Mobile Medical Simulation for Rural EMS Training, presented through UCLA Prehospital care Research Forum.
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Progress 09/01/14 to 08/31/15
Outputs
Target Audience:During Year 3 we completed the Field Operations portion of our research. We reached over 70 EMS agencies across an 11 county region of Upstate New Yorkand provided over 1000 hours of Continuing Medical Education to over 400 EMS providers. In addition to our research efforts commercial products developed under this SBIR reached an increasingly large audience. The ambulance simulator and other simulation environmentsdeveloped under the project have been sold to over 30 education programs across the US impacting hundreds of students. The simulation environments are now also in use by VA Healthcare for staff training. The software training scenario library has been licensed to over 150 educational programs in the US and internationally. In early 2015 we concluded our first international translation agreement for the scenario courseware and licensed the Russian rights to Alta Medica, Inc. Changes/Problems:HSS remains on the course set in the initial proposal. Early release of products has led to strong initial sales of 2 of the 3 products to be released.Initial reports are that the 2015 American Heart Association guidelines should require minimal changes to content previously developed. However until these guidelines are released in November we do not know the extent of changes needed. This is the only unknown for us at this point. What opportunities for training and professional development has the project provided?In the concluding year of our Validation Research we conducted 2 months worth of EMS training at 8 locations to over 60 providers. This brings the total amount of training provided during the Field Operations portion to over 1000 hours of Continuing Medical Education to 400 providers across the testbed region. How have the results been disseminated to communities of interest?Greg Vis, Project Director, now sits on the Research Committee of the National Association of EMS Educators. Through this role he has been able to discuss our research findings andadvocate for simulation as it expands in the EMS community. HSS has attended numerous annual conferences at the state level and promoted our findings andnew products to the community. What do you plan to do during the next reporting period to accomplish the goals?The primary task during Year 4 will be the completion of our online multimedia simulation package for initial and continuing education. All content has now been developed and we await release in November 2015 of the American Heart Association's newest Lifesaving guidelines which will be incorporated as needed. Content will receive final review andediting and then be assembled in final media format ( web, video, print).The need to be compliant with the new guidelines was one of the reasons we requested and received a no-cost extension for Year 4. The extension will allow us to ensure that the content will be valid for the next 5 years until 2020.One sub-component of the content is an agricultural emergencies simulation module - REACT- Rural Emergencies & Accidents Care Tactics. This will be released as both an instructor led 1 day course and as an online offering.HSS is now going through the certification processfor the Continuing Education Board for EMS (CEBEMS) so that we may offer CME credits with our content. This will be a strong competitive advantage. We anticipate a 1st quarter 2016 release for the completed product line. This will be a critical time for EMS educators and the timing is right for an evidence based EMS simulation solution such as the one we have developed.
Impacts
What was accomplished under these goals?
Our accomplishments for the three main goals of the project include: 1. Validation Research :Early in Year 3 the Field Operations for the Validation Research phase was completed. Subsequently EMS agencies in the testbed region were sent a final demographic survey for the purpose of comparing pre and post-intervention agency demographic data.Preliminary data analysis has also been completed. Using pre and post-intervention survey methods we investigated changes in Knowledge, Skills and Attitudes of EMS providers comparing simulation training and traditional educational methods. We have been able to show statistically significant improvements for EMS Knowledge, Skills and Attitudes using simulation training compared to traditionaltraining methods. We also investigated whether simulation training had any impact on recruitment and retention rates at EMS agencies. We have been able show positive results with increased simulation for recruitment and retention however the increases are not statistical significant compared to control groups. 2. Expanded Simulation Curriculum :Developing educational aids that allow faculty to incorporate the disruptive new technology of medical simulation into their programs is one of the main objectives of our program. Simulation training is being mandated toEMS programs as the national certification body, NREMT.org, will now require scenario simulation training beginning in 2016. Clear guidelines were only released during Year 3 for the new requirements. HSS attended numerous industry conferences and spoke with the NREMT to ensure our products meet the new requirements. Faculty are struggling to adapt to this complex change. Products developed in our SBIR have the goal of reducing the cost and complexity of providing effective simulation training. Early simulation scenarios were released in 2013 and have seen continued enhancements during the Year 3 period. The scenarios have achieved positive market reaction with sales in excess of $100,000 to date. Our finalproduct offering will be a series of online and video- based training programs which will further allow faculty to meet the national certification needs as well continuing education requirements. HSS is completing the development of over 40 hours of multimedia products based on the EMS research completed so far. In additon to content HSS has developed a robust online delivery platform. This product is in the final stages of development and we anticipate a first quarter 2016 release. Timing is critical to the release of any product and this is especially true in the EMS education market. The American Heart Association releases new guidelines every 5 years for lifesaving that directly impact EMS education. The next set of guidelines will be released in November 2015. Once these are released existing content must be evaluated and any changes made prior to release. Existing scenarios will also have to be revised. In preparation for final certification of our product HSS has contracted a medical director, Dr. Robert Desiderio, to review all content for accuracy. 3. Protype Simulation Package:Released in late 2013 the Simbulance ambulance simulator continues to be updated and modified to reflect market needs. During Year 3 an audio-visual option was added to the package as well as a complete interior furnishings option. In Year 3 the VA Health Administration purchased elements of the Simbulance line to use in mobile simulation traiing. We have recently added a new distributor for these products - Pocket Nurse, Inc - which is th leading provider of training materials to Nursing and Allied Health programs in the US. Our sales and marketing efforts are ongoing and to date 15 units have been sold for over $60,000 in early revenue. The Simbulance is closely tied into the new online educational package which will greatly strengthen sales going forward.
Publications
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Progress 09/01/13 to 08/31/14
Outputs
Target Audience: During Year 2 of our Phase 2 SBIR we have trained over 500 Rural Emergency Medical Service providers and volunteers across Upstate NY. We have worked with over 70 different EMS agencies and obtained wide support for our efforts. Changes/Problems: There have been no major changes in our approach to either the research or product development from the original vision. As previously mentioned , we were encouraged to release products early and sequentially by Larta and this has generated good initial revenue for the Simbulance and our scenario packages but fulfilling the orders has taken a considerable amount of time, effort and resources. An important market for us will be initial EMT- Basic level training programs. New national requirements from the American Heart Association will only be released in late 2015. This will generate a new product buying cycle in this core market beginning in January 2016. We need to anticipate the new requirements as best we can right now and be prepared to revise any affected curricula when the new standards are released later this year in order for our content to stay relevant. This is a challenge with our major content release so close to the new standards and a development that we need to monitor closely. What opportunities for training and professional development has the project provided? During Year 2 we provide over 1000 hours of Continuing Medical Education credits to over 400 providers across New York. HSS conducted career exploration activities based on simulation to assist agencies in the testbed region with new volunteer recruitment efforts including providing wide publicity for training events, attending open-houses and county fairs and local high school fairs. Preliminary research data indicates that agencies receiving simulation training had higher recruitment and retention levels of EMS providers. How have the results been disseminated to communities of interest? Greg Vis, the Project Director, wrote an online supplement on behalf of the National Association of EMS Educators on the topic of simulation and the supplement mentioned preliminary research results from the USDA sponsored SBIR which appeared in the October 2014 Journal Of Emergency Medical Services. What do you plan to do during the next reporting period to accomplish the goals? 1. Validation Research Field operations are now complete and we now move to our analysis and reporting phase. HSS will re-survey all EMS agencies in the testbed region beginning in September 2014. HSS will statistically analyze all research data beginning in September 2014. We will complete our final report by project end in August 2015. 2. Expanded Simulation Curriculum We will complete the release of both the instructor lead and online curricula as saleable items by August 2015. Content development is 75% complete at the end of Year 2 and Year 3 will see strong focus on extensive accuracy review and the development of additional audio-visual assets necessary to create market leading lessons and interactions. Continued development of the online delivery platform will be accomplished during this year. 3. Prototype Simulation Package To ensure the continued success of the Simbulance package we continue to develop the system's video capture and storage capabilties. This capability is becoming increasing important for colleges teaching Emergency Medical Services. The National curriculum is moving towards a portfolio model in 2016 and record storage is a critical component of the new requirements.
Impacts
What was accomplished under these goals?
In early 2013 HSS requested and was granted a 1 year No Cost extension for our project. HSS was able to achieve early commercialization of a number of products developed under the grant. This had the effect of extending the period required for research activities later into Year 2 than originally planned. The early commercialization has resulted in SBIR developed product sales of over $120,000 for the 2013-14 period. 1. Validation Research HSS completed the Field Operations component of research as planned during year 2. We worked with 70 EMS agencies during Year 1 and 2, mostly in year 2. Over 600 EMS providers, 25% of providers in an 11 county region larger in size than the State of Vermont, received over 1200 hours of Continuing Medical Education credits. Analysis of the results and re-survey of the region will begin in September 2014. Preliminary data indicates that compared to the control group simulation participants achieved statistically significant knowledge increases. HSS conducted activities to assist agencies in the testbed region with new volunteer recruitment efforts including providing wide publicity for training events, attending open-houses and county fairs and local high school fairs. Preliminary research data indicates that agencies receiving simulation training had higher recruitment and retention levels of EMS providers. 2. Expanded Simulation Curriculum HSS continued the development of the simulation curriculum during Year 2. The scenarios are refined through the Field Operations and validated as well. Efforts were concentrated on transforming the print based scenarios used for field training into interactive online content and the delivery mechanism necessary for this curriculum. We have now developed an online platform based on the Moodle open -source Learning Management System. Several new EMS specialty areas were also developed including one pertaining to Agricultural Emergencies. We have developed a sub-section of the larger EMS curriculum calledREACT - Rural Emergencies Accident and Care Tacticswhich focuses on low frequency but high consequence farm accidents, examples include tractor rollover, PTO entanglement, pesticide poisining and environmental emergencies. As with all the curriculum it will be available in both instructor lead and interactive online formats. We have met with the national accrediting body for EMS Continuing education and all developed content will bear national CME accrediattion in 2015. 3. Prototype Simulation Package The Simbulance simulator has met with strong market acceptance. As of the end of August 2014 ten units had been sold across the US. The product was demonstrated once again in 2014 at the National EMS Educators Conference in Reno, NV.
Publications
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Progress 09/01/12 to 08/31/13
Outputs
Target Audience: During Year 1 of our project we began field training of Rural Emergency Medical Services volunteers. The period of training is from 4.13- 8.14. From 4.14 to 8.13 we trained over 150 volunteers using advanced medical simulation using a curriculum designed for this project. Changes/Problems: At the conclusion of Year 1 the project is proceeding as planned. The release of the Simbulance product was accelerated based on input from Joel Balbien our Larta assigned consultant. Balancing product development and field research has at times been challenging however no major changes to the initial proposal are planned. What opportunities for training and professional development has the project provided? During Year 1 we provide over 300 hours of Continuing Medical Education credit to Rural EMS volunteers. Satisfaction ratings from the participants was over 95%. How have the results been disseminated to communities of interest?
Nothing Reported
What do you plan to do during the next reporting period to accomplish the goals? 1. Validation Research Field Operations and on-site training will continue at over 70 volunteer agencies during the Year 2 period. Over 70 training events are planned for the period. 2. Curriculum Development In addition to Field training this will be a major focus of Year 2. We intend to expand the number of scenarios to 50 to cover the entire EMT basic and Paramedic curriculums. 3. Prototype Development Work will continue on the development of the Simbulance ambulance simulator. Different fabrics and designs will be tested with the market.
Impacts
What was accomplished under these goals?
During Year 1 significant progress was made towards accomplishment the overall project goals. Specifics by objective are listed below: 1. Validation Research Support was obtained from the Regional EMS Councils to provide Continuing Medical Education in the region. A baseline survey examining membership, call characteristics, recruitment and retention activities and training methids was sent to the 140 EMS agencies in the testbed region. We obtained a 70% response rate to the survey. Out of the 140 EMS agencies in the testbed region , 50% were recruited to participate at different intervention levels ( 4 simulation training sessions, 2 simulation training sessions, 2 instructor lead tradition training sessions ). Training began in 4.13 and will continue until 8.13. In Year one over 150 volunteers were trained. 2. Curriculum development A simulation curriculum consisting of 24 different scenarios and associated materials ( powerpoint lectures and test items) was developed to be used in the training sessions. 3. Prototype Simulation Package In August 2013 a commercially available ambulance simulator, the Simbulance, was released at the National association of EMS Educators conference in Washington, DC. www.simbulance.com The simulator is a low -cost replacement for expensive simulators and provides a very realistic training environment complete with video capture capabilities. The trademark Simbulance was registered for HSS in June 2013.
Publications
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