University of Wisconsin–Madison
Paramedics place a breathing tube in a manikin during a high fidelity simulation training.

Simulation

Simulation is an educational technique that uses guided experiences to replicate real-world scenarios. This is an effective form of adult education because it helps to build knowledge and behavior through experience. As clinicians practice procedures and decision-making in this controlled environment, they have the psychological safety to make mistakes and learn from them. By integrating simulation cases with a robust quality improvement program, it is possible to use this educational technique to strengthen particular aspects of an organization’s service delivery.

UW EMS physicians partner with the UW Health Clinical Simulation Program and the UW Health Emergency Education Center to bring unparalleled amounts of simulation resources and expertise to training.

Photograph of two rescuers practicing a rescue of a low-fidelity manikin.

Low-Fidelity Simulation

Low-fidelity simulation uses static, simplistic representations of real-world simulations. Examples of low-fidelity simulation are task trainers such as IV arms or CPR manikins. Though less immersive than high-fidelity simulation, this type of simulation is more accessible and cost-effective, allowing multiple learners to practice simultaneously. Low-fidelity simulation may also be preferable when training objectives are highly specific or less clinically oriented.

Dr. Genthe reaches into a crevice to perform a field amputation on a simulated patient entrapped in a boulder field.
The field amputation was performed by a UW EMS fellow.

High-Fidelity Simulation

High-fidelity simulation is a realistic and immersive method that uses more lifelike manikins or actors. Whenever possible, we conduct high-fidelity simulations in real time and minimize “verbalization” of exam or skills to emulate actual experiences. This method of simulation is more labor-intensive, but provides learners with an experience as close to real life as possible.

BADGER-3 Training Ambulance

UW Health has the only dedicated training ambulance in the region (BADGER-3). This fully stocked and functional ambulance can be equipped with a high-fidelity manikin and brought to various training sites to improve the realism of training for EMS clinicians.

EMS clinicians watch a simulation unfold in the back of the BADGER-3 training ambulance.
EMS clinicians watch a simulation unfold in the back of the BADGER-3 training ambulance.
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Clinicians dressed in hazardous materials suits attempt to perform a procedure on a manikin in the back of the BADGER-3 training ambulance.
Clinicians test their dexterity attempting to intubate a critically-ill, contaminated patient in the back of the BADGER-3 training ambulance.
Aerial view of the BADGER-3 training ambulance.
Aerial view of the BADGER-3 training ambulance.

Spotlight: Technical Rescue Emergency Care

In 2024, Dr. Spigner teamed up with instructors from Elevated Safety LLC to deliver the inaugural Technical Rescue Emergency Care course. This course was designed for experienced rescue technicians to learn methods for integrating emergency medical care and treatment during evolving rescue scenarios. The highly scenario-based education incorporated a full-length, high-fidelity scenario of a hiker that became entrapped by boulders in a remote location, requiring rescue paramedics to partner with an EMS physician to perform a field amputation. To enhance realism, the leg was simulated using a real tissue bovine (cow) leg that was articulated to a high-fidelity mannequin.

A high fidelity manikin entrapped in a field of boulders before rescuers arrive.
The manikin was entrapped by its leg in a limitd space.
A close up of the bovine (cow) leg that was used to simulate a human leg during a field amputation exercise.
View of the amputated limb, a live tissue bovine leg that was articulated to the manikin.
Rescuers walk a simulated patient out of the wilderness on a wheeled litter.
Team members practiced walking a patient out of the wilderness.
Rescuers needed to work to stabilize the patient in place while preparing for a field amputation.
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