Healthcare simulation mobile labs provide a transformative solution for the advancement of professional development and improvement of patient safety in rural areas. These mobile units bring high-fidelity simulation training directly to healthcare providers who may otherwise lack access to hands-on learning opportunities. Replication of real-world medical scenarios in a controlled environment, simulation labs enhance clinical skills, improve critical decision-making, and foster teamwork among rural healthcare professionals. This HealthySimulation.com article by Carrie Gigray, MSHS, CHSE, CHSOS, NRP, will examine the recent launch of Texas’ first mobile simulation lab (MSL) in addition to the overall mobile healthcare simulation landscape of the United States.
Rural Health Care Hospitals and Clinics in US Overview
Critical Access Hospitals (CAHs) and Rural Health Clinics (RHCs) play a vital role in emergent, primary, and preventive care to rural populations, but they often operate with limited resources. Between 2013 and 2020, over 100 rural hospitals closed their doors for good. In 2021, the Critical Access Hospital Measurement and Performance Assessment System (CAHMPAS) Data Summary reported that 64.3% of Critical Access Hospitals provided Rural Health Clinics. Compared to other high-income countries, the United States has fewer midwives and obstetricians and higher racial disparities in maternal and neonatal mortality, particularly in rural areas.
Over 60% of rural Americans rely on these healthcare resources, yet despite their importance, these hospitals and clinics struggle with financial sustainability, workforce shortages, and difficulties to provide specialized services. This lack of accessibility can lead to delays in diagnosis and treatment, negatively impacting health outcomes.
Many rural counties are classified as Health Professional Shortage Areas (HPSAs), which means there aren’t enough primary care providers to meet the needs of the community. In 2019, 40% of rural counties faced full-county primary care shortages, and 81% had mental health provider shortages. These shortages create difficulty for residents to receive routine check-ups, preventative care, and mental health support, which contributes to higher rates of chronic disease and untreated mental illness. The rural mobile simulation approach bridges the gap in continuing education to ensure providers in remote communities receive the training necessary to deliver safe, high-quality patient care.
First Mobile Simulation Lab Debuts in Texas to Address Health Disparities
Texas is no different, with nearly one-fourth of the population in a rural community, there are only 163 rural hospitals. Out of 163 hospitals, just 70 provide obstetrical care, leaving communities without access to essential maternity services. The Center for Rural Health and Nursing at The University of Texas at Arlington (UTA)was established in October 2021 to enhance healthcare access and outcomes in rural Texas communities. Part of the College of Nursing and Innovation education and training aims to address the nursing shortage for rural nursing professionals.
A key initiative is the Mobile Simulation Lab (MSL), designed to deliver advanced healthcare simulation directly to rural and underserved areas to improve the skills and confidence of healthcare providers. The center hosts an annual Rural Health Conference to support collaboration and professional development among rural healthcare professionals of all disciplines. Uniquely they also provide grant writing and publication courses to support professional development to build sustainable partnerships.
The state-of-the-art 40-foot mobile simulation lab aims to serve community needs to provide continued education for high-stakes, low-frequency situations, such as maternal, neonatal, and pediatric emergencies, as well as stroke and trauma emergencies. With two simulation suites and two high-fidelity simulators, MLS provides innovative simulation opportunities through partnerships with critical access hospitals and clinics that will facilitate clinical education and certification programs intended to enhance healthcare access, particularly in maternal and neonatal care.
Helmsley Charitable Trust Grant Awardees and Partnerships for Rural Simulation.
The Leona M. and Harry B. Helmsley Charitable Trust’s vision is “Better futures for people by increasing access to healthcare, advancing new research ideas, and improving the quality of everyday life.” This global philanthropy has been funding impactful healthcare innovation for since the 1930s. In addition to international causes, chron’s disease, and type 1 diabetes, rural healthcare is a top priority.
In 2015 Montana Department of Public Health and Human Services received a Helmsley Charitable Trust $ 4.5 million grant to create a statewide mobile education training system to address rural healthcare challenges. Simulation in Motion Montana (SIM-MT) was on the road in 2017 to address educational disparities to bridge between rural and urban healthcare providers’ available simulation education. Established as a 501(c)(3) non-profit organization, SIM-MIT received continued grant awards from the Helmsley Charitable Trust (2019 – 2022) and relies on corporate sponsorship, in addition to university and organizational partnerships to maintain sustainability.
The 2024 annual report states all Montana counties are considered “ambulance desserts,” with more than sixty percent of prehospital providers services volunteer. Ground ambulance transport times to specialized care for rural areas average 3 hours. Therefore, it is imperative for prehospital providers to have available continued medical education to help improve patient care outcomes. Healthcare simulation provides professionals the opportunity to practice in a no patient-harm environment to build confidence and practice necessary skills. 2436 interdisciplinary learners from forty-five of the sixty-five counties in Montana received healthcare training in a variety of settings from the mobile simulation center, in-situ, and online in 2024, and nearly 20,000 students since 2017.
Simulation in Motion South Dakota (SIM-SD) is a program dedicated to enhance emergency medical education with healthcare simulation training for healthcare providers in rural areas. Through a collaborative effort among the South Dakota Department of Health, Avera Health, Regional Health, and Sanford Health, SIM-SD was launched in 2012 with the goal to improve patient outcomes through high-risk, low-volume healthcare simulation training experiences.
Initial grant award funded 3 mobile simulation units with all the needed equipment for medical training to allow SIM-SD to complete their mission to develop a statewide system to provide access to theology advanced training to enhance the delivery of emergency patient care in rural and frontier South Dakota. In 2014 Helmsley Charitable Trust again supported the Cardiac Care Project with a $ 3.7 million grant to provide approximately 200 LUCAS devices, an automated continuous chest compression machine for cardiac arrest, to rural emergency medical services and critical access hospitals with over 450 healthcare workers trained in the equipment by 2015. In 2018 a third grant gave SIM-SD to fund the outfit the medical simulation labs with obstetric simulators to address maternal health in rural populations. Sustainability is continued through grant funds and charitable donations with Avera Health, Regional Health, and Sanford Health.
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Like SIM-SD, Simulation in Motion Iowa (SIM-IA) has three mobile healthcare simulation trucks who travel the state to provide EMS providers and other emergency caretakers, valuable medical education which might not otherwise be obtainable. In 2019 the University of Iowa College of Nursing found less than forty percent of agencies and hospitals provided hands-on continuing education for EMS and rural hospital education. The critical educational situation could impact the nearly forty percent of Iowanians who live in these rural communities. Supported by the Helmsley Charitable Trust awarded a 7.9 million dollar grant in partnership with the University of Iowa, SIM-IA hit the ground in 2020. The standardized curriculum throughout the state assures uniform educational opportunities to enhance critical thinking, skills, and team performance in critical care crisis management all through healthcare simulation.
Another mobile simulation lab is Simulation in Motion North Dakota. Initially funded by Helmsley Charitable Trust in partnership with the University of North Dakota (UND), North Dakota’s tertiary hospitals in Bismarck, Fargo, Grand Forks, and Minot, and the state’s Department of Health and Human Services in 2013. According to American Health in 2023, thirty-nine percent of North Dakota residents live in rural areas, with almost 46 percent of those individuals 65 years or older.
The mobile simulation utilizes high-fidelity human patient simulators to provide on-site training to critical access hospitals, EMS personnel, and other first responders to improve patient outcomes. Coordination is provided by the University of North Dakota School of Medicine and Health Sciences for the four 44-foot mobile simulation lab trucks stationed in Fargo, Grand Forks, Bismarck, and Minot. As of November 2024, SIM-ND has conducted 345 events, averaging 862.5 hours of training, and has educated 4,415 learners. In addition to the education of healthcare professionals, SIM-Midwest, Simulation in Motion Consortium holds an annual mobile simulation conference.
The University of Nebraska Medical Center (UNMC) iExcel also received a $5.5 million dollar grant from the Helmsley Charitable Trust in 2016 to launch a mobile simulation unit but were unable to maintain sustainability and have moved to sprinter vans to provide healthcare simulation to rural and underserved healthcare systems to include EMS and critical access hospitals throughout the state.
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Shelden Clinical Simulation Center Mobile SIM at Missouri School of Medicine
Part of the Russel D. & Mary B. Shelden Clinical Simulation Center the Mobile SIM, established in 2011, is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services as part of a $19 million dollar grant. The center is dedicated to the continuous improvement of people and processes, to transform healthcare education through medical simulation. With a 30 ft mobile simulation lab capable of two simulation opportunities managed simultaneously, educational opportunities are plentiful for rural patient care providers. In addition to the mobile simulation truck, SCSC has two simulation ambulances to train first responders housed at the Springfield and Columbia locations.
Parkview Mobile Medical Training Lab for Prehospital Providers of Indiana
Parkview Mirro Center Simulation Lab is part of Parkview Health, a not-for-profit, community-based care system which serves 20 counties in northeast Indiana and northwest Ohio. In late 2023 the Emergency Medical Services (EMS) Foundation, part of the Fort Wayne Medical Society in partnership with the healthcare simulation center established the Mobile Medical Training Lab (MMTL). The mobile medical simulation unit is designed to bring innovative education and healthcare training to rural prehospital providers such as EMS, fire departments, and law enforcement.
Learn More: Building a Mobile Simulation Lab for Better Patient Outcomes
