FULTON, Mo. — Within the last 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 staffing shortages or economic challenges. Now, a 38-foot RV is traveling in Missouri with state-of-the-art equipment and simulations to train first responders. 

You won’t find another one like it in Missouri, a one-of-its-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 kinds of patients at the same time,” Director of Simulation at the University of Missouri School of Medicine Dena Higbee said. “They [trainees] can experience anywhere between infants, pediatrics, adult care or even birthing simulations.”

Higbee said 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. 

“We’re at the point now where we’ve been able to expand to have more simulators available,” Higbee said. “We have a greater need throughout the rural community due to staffing shortages. When they [trainees] comes in and see that their [simulators] are actually blinking, that it can react, follow you and that their chest actually rises, and their vital signs are responding, that’s where aha moment occurs.”

The brand-new custom-built RV is traveling rural Missouri to provide hands-on simulations, training first responders and health care 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,” the five-year-old simulator said while crying. “Don’t touch me.”

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

The scenarios are controlled from an operator behind the wall in the control room, operating the vital signs, the talking and noise from the simulator and giving the first responders information about the call. 

“There are two cameras in the ceiling and there is a microphone where we’re able to record the scenarios and then we can play back video for the debrief afterward,” Higbee said. “Being able to take this kind of equipment that is more high-tech and actually immediate response needed to care for the patient, it just enhances the kind of training they’ve {the trainees] had in the past.”

The patient’s vitals are displayed on a monitor in either room, allowing the 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.”

With the status 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 throughout the years because of those smaller hospitals closing,” Higbee said. “Your first responders, whether it’s a community hospital or if it’s your EMTs, they really are your first line of defense of better patient care.”

Over the next six months, with the help from a federal Health Resources and Services Administration (HRSA) grant, the Mobile Simulation Center will travel across the state to provide 20 free trainings. During those 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 more excited when I’m out on the road doing these rural trainings because you get to see that moment for the folks who are not used to simulators,” Higbee said. 

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