Ambulances & Vehicle Ops, Training

South Dakota Mobile Simulation Program Brings Training to Rural Providers

Issue 1 and Volume 40.

Most of us in EMS go to a community college or training center for EMT, certified first responder or paramedic training, but what about those in rural areas who don’t have that opportunity?

In 2008, the South Dakota Department of Health (SDDH)—which administers EMS programs throughout the state—wanted to create a way to train public safety officials in rural areas. Department officials looked at traditional simulation training centers around the country, but wanted something different, and ultimately decided on a mobile simulation training program.

The program, called Simulation in Motion–South Dakota (SIM–SD), brings training to rural medical providers via three custom-made mobile simulation labs. It includes five healthcare sites—three regional EMS agencies and two smaller hospitals that are involved with the training. It’s administered by the SDDH, Avera Health, Mobridge Regional Hospital, Regional Health and Sanford Health.

SDDH officials had a list of goals for the program’s creation:

>> To ensure quality healthcare for all South Dakotans;
>> To develop a statewide system to provide access to technologically advanced training that would enhance the delivery of emergency patient care in rural/frontier South Dakota;
>> To provide increased educational outreach opportunities for emergency care personnel in rural communities;
>> To enhance competence and confidence among rural emergency care personnel;
>> To strengthen relationships between prehospital and hospital emergency care personnel to facilitate consistency of care; and
>> To reach each hospital and ambulance company in the state at least once a year.

Lifelike training manikins increase the realness of the ED simulator.


Building the Vehicles

Rosenbauer—known mostly for its fire apparatus—was selected to build the three 44-foot long custom mobile labs because of the company’s local ties and reputation of building strong vehicles. SDDH representatives wanted a fire-service-type of construction so the vehicle would be stronger than regular units. A four-door cab was selected to make transporting the training crews easier, and aluminum subframes and superstructures provided a light but strong body. Diesel generators and auxiliary roof-mounted heat and air conditioning units were also installed.


Most rural EMS workers only come across a critically ill or injured patient a few times per year. The SIM-SD training gives them the opportunity to train with these types of injuries and keep their skills fresh with special lifelike training manikins. The three models—iStan for adult training,
PediaSim for children training and BabySim for infant training—are some of the most technologically advanced training tools available because the manikins can breathe, talk, sweat, react to medication and die. 

The vehicles provide training for all areas of prehospital medicine. Each simulates an ambulance in the rear and an ED in the front. The center of the vehicle is a computerized simulation command center.

Avera Health, Regional Health and Sanford Health operate one simulation vehicle each. Two smaller outreach vehicles are also available for localized training in the central part of the state.

The program has been so successful that seven additional states are now looking into adopting this model.

The ambulance simulator is located in the front of each truck.



The funding for the program came partially from federal money and a one-time grant of $5.6 million from The Leona M. and Harry Helmsley Charitable Trust Rural Healthcare Program, which funds innovative projects using information technologies to connect rural patients to emergency medical care, bring the latest medical therapies to patients in remote areas and provide state-of-the-art training for rural hospital and EMS personnel.


Medical training in South Dakota has taken on a new look. These custom-manufactured, simulator-based units are traveling the state and providing intense, hands-on training. If you’re in the process of expanding your training to reach rural areas, this agency is a great model.