From early DOS training programs, which consisted primarily of test question banks, to the more recent video or laser disk simulations, EMS training software has come a long way. Recently, some great virtual classroom applications using the Internet have emerged. The Web will play a major role in future EMS education and distance learning. However, not all students currently have access to the Internet at home or at an EMS station. That's where a new breed of computer simulation software comes in. Brady's new computer-based Medical Emergency Response Simulator (MERS) is fun, educational and highly interactive. It improves critical decision-making and documentation skills for EMS students and practitioners.

New breed of teaching tool

If you like interactive, scenario-based simulations, this program's for you. MERS uses high-quality graphics, sound and animation to simulate medical and trauma incidents. Each scenario dispatches the player to an emergency, where they conduct a scene survey, assess and treat a patient.

The quality of the graphics makes you consider mechanism-of-injury factors as you approach the patient. Example: As you near a campsite in a remote area, you hear birds singing and a waterfall flowing. Then as you approach the patient, seated on the ground and in obvious pain, you see a fire burning, loose rocks in the area and a few glass bottles littering the site.

The MERS program comes with a tutorial and 13 different scenarios. With each scenario, you can choose between beginner, intermediate and advanced skill levels-at three speeds. Just as in real life, you'll "feel the need for speed." The clock ticks away as you practice EMT skills on Victor, one of the lifelike patients you'll encounter. Victor answers your questions. In game-style play, you get to practice vital patient-assessment skills, make treatment and transportation decisions and practice documentation. The simulation offers practice with a wide range of experiences and problems EMS professionals encounter in the field. Treatment protocols, documentation and evaluation conform to the DOT EMT-B curriculum.

The MERS program comes with thirteen different scenarios and a tutorial scenario. With each scenario, you can choose between beginner, intermediate, and advanced levels of skill, and three levels of speed. You can start with easier calls and build on your knowledge and experience to more difficult situations.

Just as in real life, you will "feel the need for speed." The clock ticks away as you practice EMT skills on "Victor," one of the lifelike patients you'll encounter. Victor talks to you in response to your questions. This interactive aspect of MERS is what makes it so cool.

Real EMS systems measure patient outcome. MERS does the same with its outcome-focused evaluations. Users are evaluated on actions in the context of overall patient outcome, which includes separate evaluations for scene assessment, patient assessment, treatment rendered and documentation completed. After all you Johnny and Roy wannabes think you've saved the patient, MERS will prompt you to click on the evaluation icon find out how you really did. It will be a humbling experience. I can imagine some really fun competition within the classroom setting or just between shifts as you and your colleagues compare printouts.

The license minefield

One of the problems with software is often licensing. Even in the most vigilant agency it's difficult to insure that use of a program is accomplished in a manner that doesn't violate the software license agreement. The MERS program runs directly from the CD, there's nothing to install on your computer. Because there's nothing to install, you can pass the CD-ROM around your agency for training and not have to worry about software piracy issues. To get started, all you do is place the CD-ROM in the computer and select "Run" from the Start Menu. Enter MERS and hit the enter key.

System requirements and ordering information

Remember there's no installation required. This program runs entirely from the CDROM. However, here are some requirements for your PC or MAC:

• Windows 95/98/NT; 133Mhz Pentium, 32M memory; 6X CD drive; 256 colors; speakers.
• Mac (PowerPC processor) with 14M of available free memory; 4X CD drive; speakers.

The MERS program is priced at $350. To order, contact Brady Publishing, 800/638-0220, via e-mail at brady_ems@prenhall.com or visit www.bradybooks.com.

Mark O'Keefe, EMT-P, is the community information officer for EVAC Ambulance, Volusia County, Fla., and writes for EMS Manager & Supervisor. He also serves on Florida's new technologies and medications team and can be reached via e-mail at Mark@OKeefes.com.

New on the market is a CD of interactive scenarios for EMT-Basic training: The Medical Emergency Response Simulator (MERS), touted as the most realistic on-screen simulation available. The simulator allows the participant to interact with Victor Hurt (the patient), ask questions, take vital signs, palpate and move the patient, and more.

The program's goal is to give students a place to practice decision-making skills before they head into the real world of the streets. The scenarios give users a chance to practice scene size-up, patient assessment, treatment and transport decisions, and proper documentation. At the conclusion of a call, the program furnishes an evaluation for students to assess their strengths and weaknesses. Over time, evaluations can be compared, so that skill improvements can be noted.

MERS can be used in a number of ways in the classroom or students can use the program independently to hone and review skills. The CD has a tutorial case study that allows the user to become familiar with all the tools and interface opportunities inherent to the program. Users can fine-tune their use of the 13 different emergency scenarios by choosing clock speed (slow, normal, or fast) and level of difficulty (tutorial, any call, beginner call, intermediate call, advanced call, or selected call). The program is compatible with both Windows and Macintosh platforms, and requires no installation.

The CD was sent to MERGINET reviewer Heath Oustad, who had the following comments. I have just finished evaluating (playing with!) the Brady MERS CD. I thought it was fun and good for an alternate source of learning.

The pros:

• It keeps your attention and time seems to fly by when you are using it.
• It is very efficient at evaluating documentation skills, especially for new EMTs.
• I found that it does make one understand the flow of an EMS call, which is good, because that is usually something that comes with experience. This is not something that can be taught in a classroom environment.
• I do like the fact that it makes you have to think about what you want to do to properly treat a patient, in a timely fashion.
• Finally, I loved the evaluation it provides at the end of each scenario. It is a very unbiased evaluation. As an instructor, there are times when it is hard to evaluate students fairly when you are thinking what you would do in the same situation. This allows students to run calls in their own way.

The con:

• The cost seems expensive for the average Joe, since the majority of EMT-Basics are volunteers (full version: $350; valuepack of five for $999, valuepack of 10 for $1,599 - prices subject to change). However, if the marketing focus is on training institutions, the price is fair.

In closing, I want to say that I did enjoy this product and found it educational and entertaining. For more information about the Brady MERS CD, call (800) 638-0220 or visit www.bradybooks.com.

"The MERS program is probably the best union of technology and real world EMS patient care I have ever seen. The interaction of the "Rescuer" with the patient is not only a valuable way of gaining experience in patient assessment, but it even more importantly provides very valuable feedback to the user, in a non-threatening manner. Providing a program that truly puts the decision making and all the tools of the trade at the disposal of the user, reinforces the thinking and acting that are both important parts of evaluating and treating patients.

When a prehospital provider tries to act from "book learned, rote memory" the process of information gathering is relatively inflexible and does not allow for the application of input based on the information gathered.

I am particularly impressed that the program actually allows the student to make the patient better or allows them to get progressively worse. It is a real world approach that rewards the caregiver for proper decision making and information gathering, and allows them to practice and hone their lifesaving skills on a "patient" that responds to the treatment applied. Users are provided with a written "Report card", to enable them to refine their techniques and improve their abilities. I highly recommend this product as a learning tool for new, and a valuable easy to use con ed tool for existing, caregivers.

It is not only highly educational, it's a safe and fun way to learn."

     Lou Jordan, President Emergency Training Associates