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Simulation in Motion-South Dakota (SIM-SD) EMS Educational Outreach Program

  • Need: To provide increased educational opportunities for emergency care personnel in rural and frontier South Dakota.
  • Intervention: A technologically advanced training was created to enhance the delivery of emergency patient care.
  • Results: Hundreds of emergency medical services (EMS) staff and volunteers received training that in turn helped them in the field of emergency patient care.


SIM-SD logo In 2010, Simulation in Motion-South Dakota (SIM-SD) was created through the partnership of the South Dakota Department of Health, Avera, Regional Health (now Monument Health), and Sanford Health.

SIM-SD offers statewide training to prepare emergency healthcare providers for critical situations. In South Dakota communities, many pre-hospital and hospital emergency care personnel only encounter a critically ill or injured patient once or twice a year. SIM-SD is a mobile education program designed to give providers, many of whom are volunteers from rural areas, the chance to encounter crisis situations of illness or injury multiple times with focused feedback. Providers work toward the comfort, competence, and confidence necessary for actual emergency calls.

Educational training is done through the use of human-like patient simulators (computerized mannequins). These simulators can talk, cry, sweat, react to medicines, breathe, bleed, and express many other humanoid characteristics vital to proper training. Essentially, for any medical training situation programmed into the computer, the mannequin will act as the appropriate patient for the case. It's as realistic as training can be outside of the actual situation.

SIM-SD takes place in a truck that pulls right up to a facility. The inside of the 44-foot custom-built mobile learning lab is split into two sections. The front half resembles an emergency room while the back half is identical to an ambulance. In addition to the mobile learning labs, smaller outreach vehicles are also available to provide training. Both the learning labs and the outreach units are equipped with patient simulators and a standardized educational curriculum.

The mobile learning labs and outreach vehicles were provided through grant funding from the Leona M. and Harry B. Helmsley Charitable Trust.

Services offered

SIM-SD uses a standardized curriculum that ensures uniform educational opportunities for all South Dakota emergency care personnel. The program's training includes multiple pre-programmed scenarios for adult, child, and infant patients.

iStan/METIman (adult patient) has several programs, including:

  • Medical
  • Respiratory
  • Trauma
  • Cardiac
  • Neurologic

PediaSIM (child patient) and BabySIM (infant patient) have several programs, including:

  • Medical
  • Respiratory
  • Trauma

In 2018, each of the three healthcare partners received a high-fidelity obstetrics (OB) simulator, which provide a number of delivery options from normal delivery to the most extreme OB emergencies.

Training scenarios are video-recorded for evaluation purposes. After a training scenario is completed:

  • Educators debrief and evaluate how the participant handled the situation (what went right, what went wrong, what could be done differently next time)
  • Critique is done in a supportive manner conducive to learning


From the program's inception to the end of 2016 (the official end of the grant evaluation process), there were:

  • 1,320 trainings provided statewide
  • 19,131 participants reached

A follow-up survey was sent out a month after training. The survey findings include:

  • 88% of participants agree/somewhat agree: "I have used the skills learned in my work."
  • 92% of participants agree/somewhat agree: "Because of the training I received, I have improved my skills."
  • 89% reported some/much when asked: "How much of the information/skills obtained in the training have you used in your EMS or related work?"
  • 83% reported some/much when asked: "As a result of the training you received, has patient care/safety at emergency site changed/improved?"


Working with three competing health systems would normally be considered a challenge; however, this collaboration has gone very smoothly. In addition to state policies and procedures, each system has its own unique rules and requirements. Because of these differences, considerable time and effort were spent incorporating a program of this magnitude into existing structures.

In 2016, the SIM-SD program finished up with its initial grant funding opportunities. SIM-SD has had to adjust and modify over the years in preparation for post-funding sustainability. Funding from the state and the three health systems are currently providing for the continuation of SIM-SD.

Given the volunteer nature of EMS in South Dakota, some trainings in regions were hard to schedule. From time to time, weather also impacted training schedules.


Funding is a major help to starting a program such as SIM-SD. The custom-built mobile units and high-tech training mannequins are expensive.

Open communication and loyalty to the program among partners was something SIM-SD program creators noted for its success. For instance, the Leona M. and Harry B. Helmsley Charitable Trust funding for SIM-SD was received by the State Department of Health. From there, the State Department of Health granted funds to project partners. For SIM-SD, this meant dividing the duties in the office and relying on the partners to accomplish those tasks.

Contact Information

Marty Link, Project Coordinator
Simulation in Motion-South Dakota

Emergency department and urgent care services
Emergency medical services
Emergency medical technicians and paramedics
Health workforce education and training

States served
South Dakota

Date added
January 5, 2016

Date updated or reviewed
February 8, 2023

Suggested citation: Rural Health Information Hub, 2023. Simulation in Motion-South Dakota (SIM-SD) EMS Educational Outreach Program [online]. Rural Health Information Hub. Available at: [Accessed 25 April 2024]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.