HCMC NETWORK FEATURE: Innovative HCMC/Ridgewater program trains paramedics for rural and metro Minnesota

Where do paramedic students get to train in the busiest Emergency Department in Minnesota, in a nationally renowned Burn Center, in Level I Trauma Center operating rooms, and diverse clinical departments in both metro and greater Minnesota medical centers (Photos 1-3)?  Where do they train with experienced paramedics in both rural and metro ambulance services (Photo 4)?  And where are didactic and skills training supplemented by simulation training and field training in vehicle extrication and rappelling (Photos 5- 8)?  HCMC Emergency and Critical Care Education has partnered with Ridgewater College, with campuses in Willmar and Hutchinson, to create a one-of-a-kind paramedic program that offers the best of rural and metro Minnesota settings for pre-hospital and hospital-based clinical training, as well as comprehensive classroom and skills training.   With its 5th class recently graduated, the HCMC/Ridgewater paramedic program has a unique history of innovation and collaboration, high graduation rates, national board pass rates and employment rates, and a reputation for excellence.  To date, the program has graduated nearly 140 paramedics who have gone on to work with rural, urban and suburban ambulance services across Minnesota, from Hibbing to Mankato, Willmar and Hutchinson to Redwing, as well as the metro area.

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In the fall of 2005, metro and rural ambulance services in greater Minnesota needed paramedics and high-quality local training programs.  Bev Hartzburg (Willmar Ambulance Service and Ridgewater College), Mike Boehme (Dean of Instruction, Ridgewater College), Charlie Moen (Director of EMS Education, HCMC), and Brian Mahoney (Medical Director, Hennepin EMS) set about to develop an accredited paramedic program that would draw on unique facilities and expert personnel at HCMC and Ridgewater College and build a collaborative program that would equip students for paramedicine practice in both rural and urban Minnesota.   The innovative program was launched in March 2007, graduating its first class of 28 paramedics in 2008.

The program makes extensive use of innovative technologies.  Lectures by experts from diverse fields are broadcast live from an HCMC classroom in Minneapolis to the Hutchinson or Willmar campus (or vice versa), by internet TV and Adobe Connect.  Audio connection and a projection of students in the off-site classroom at the back of the lecture classroom enables lecturers to interact with students in both locations; lectures are also recorded for later viewing (Photos 9- 11).  Clinical lectures cover topics from anatomy and physiology, pharmacology, and pulmonology to childbirth, pediatrics, geriatrics, and care of patients with special needs.  Situational training includes lectures on tactical emergency medicine, verbal judo, medical incident command, hazardous materials incidents, rescue awareness, ground and air transport, and crime scene awareness.  Extensive skills training includes labs in airway management, patient assessment, cardiac emergencies and advanced cardiac life support (ACLS), IV placement, medication administration, and other critical skills, all taught at both HCMC and Ridgewater sites (Photos 12-14).  Ridgewater College, a pioneer in simulation training, also provides multiple simulation training options.  Scenarios are run in a simulated apartment, an ambulance, and a mobile simulation lab (Photos 15-16).   Ridgewater also offers paramedic students from both sites an opportunity for skills and teamwork development through yearly simulation training with nursing students during Willmar Trauma Days (Photo 18).  Both sites also provide field training at public safety training sites to acquaint students with basic techniques of vehicle extrication, belaying and rappelling (Photos 19-22).

The HCMC/Ridgewater program is unique for its extensive hospital-based clinical training and range of high-quality sites.  Students train with expert clinical teams in diverse departments at HCMC, Rice Memorial Hospital in Willmar, Hutchinson Health Services, Ridgeview Hospital in Waconia, and Montevideo Hospital, gaining valuable exposure to a range of hospitals and clinical settings.  Students get hands-on training through clinical rotations in the Emergency Department, Intensive Care Units, Labor and Delivery, Pediatrics, Anaesthesia/Operating Room (OR) and other departments.  HCMC is a Level I Adult and Pediatric Trauma Center and provides students the opportunity to train in the busiest Emergency Department in Minnesota, with a diverse patient population and high levels of acuity (Photos 23-24).  With an OR Suite open 24/7 and approximately 40 surgeries performed on an average weekday, the HCMC Anesthesiology/OR rotation provides students with critical training in airway assessment and management (Photos 25-26).  HCMC also offers opportunities to train in specialized services such as the Cardiac Catheterization Lab and medical, pediatric and neonatal Intensive Care Units, as well as access to the Burn Center (Photo 27) and Acute Psychiatric Services, which are unique facilities in the state and region (read more about the HCMC Burn Center and Acute Psychiatric Services).  Throughout HCMC and other clinical sites, paramedic students work with skilled staff who are committed to teaching and incorporating them into the clinical team.

The HCMC/Ridgewater program also provides unique exposure to both metro and rural pre-hospital training.  Students train with dispatch and ride with experienced paramedic preceptors at Hennepin EMS (at HCMC) and with Willmar Ambulance Service, Hutchinson Ambulance Service, and/or Gold Cross Ambulance Service in St. Cloud.  Students progress from Basic Life Support (BLS) skills to Advanced Life Support (ALS) skills, practicing first as paramedic team members and finally as team leaders, under the close supervision of seasoned preceptors (Photos 28-30).  Training with Hennepin EMS gives students valuable experience with a high-volume service (approximately 60,000 runs/year), a diverse urban and suburban patient population, a wide range of medical conditions, transport to 29 metro hospitals, and exposure to large scale incidents (fires, explosions, multiple car crashes) that may involve incident command of multiple responding agencies.  Training with Willmar, Hutchinson, and St. Cloud ambulance services exposes students to management of diverse calls in rural settings, from farm accidents and motor vehicle collisions on remote rural highways to a full spectrum of medical calls, with potentially longer transport times and more extended contact with critical and non-critical patients than metro services.  Rural services also provide ALS back-up to BLS services in more remote areas; Willmar Ambulance Service, for example, responds to calls from its primary service area as well as to requests for “intercept” transfers of critical patients from first responders in and beyond Kandiyohi County (read a blog about Willmar Ambulance Service).  Training with both metro and rural ambulance services acquaints students with diverse conditions and settings, equips them for the practice of paramedicine across the state, and informs their choices about future employment.

Roger Younker (HCMC Program Director), Phil Rach (HCMC Program Coordinator), Tracy Oevermann (Ridgewater Program Coordinator), and Tim Murphy (HCMC Program Technical Coordinator) bring extensive field, teaching, and technical experience to the program.  Students bring valuable job experience from work in fire and police departments, 911 dispatch, and ambulance services across Minnesota.  Beyond fulfillment of required rotations and rides at both metro and greater Minnesota sites, students choose elective rotations and balance the overall mix of rural and urban sites according to their schedules and interests.  Although the time commitment and demands of the program are significant, evening and Saturday classes, choice between metro and outstate classes, and self-scheduling of clinical rotations and ambulance ride-alongs make the program accessible for students with families and jobs.  Program options include a two year Associates Degree in paramedicine as well as a 12-month certificate program.

Dr. Brian Mahoney, Hennepin EMS Medical Director, feels the program and students benefit from experienced staff and close collaboration.  “If you add up the years of experience of the instructors, clinical staff, and preceptors, you have hundreds of years of real world, hands-on experience in what works, in the field, taking care of real patients.”  Ridgewater College Dean, Mike Boehme, agrees, adding that the program is unique in the region for its extensive access to expert lecturers and its provision of both rural and metro opportunities, enabling students to experience the entire spectrum of services that paramedics provide in the workforce.  Bev Hartzburg says that she and Charlie Moen realized early on that collaboration and cooperation between the rural and metro institutions and ambulance services was key, particularly in times of scarce resources.  “It’s better to work together and it makes for a great experience for students, to give them the best that you can give.”

The program has yielded impressive results.  In 2009, it earned full 5-year accreditation from the Commission on Accreditation of Allied Health Education Programs, a noteworthy achievement, particularly for a first-year program.  Graduation rates, National Registry exam pass rates, and employment rates of the program are high.  Support in Willmar and Hutchinson is strong and the community is very pleased with the paramedic graduates; extensive ride time with local ambulance services builds familiarity with performances and local opportunities, with many students staying to live and practice in the area.  The program has now graduated a total of 136 students, 96 from the HCMC site and 40 from Willmar/Hutchinson.  Graduates have gone on to work across the state, with ambulance services and fire departments in Willmar, Hutchinson, Montevideo, Litchfield, St. Cloud, Hibbing, Rochester, Red Wing and Waconia as well as Minneapolis, Prior Lake, Burnsville and other communities.

The class of 2012 graduated 27 students, 20 from the HCMC site and 7 from Ridgewater (Photo 31).  The current class has 30 students at HCMC and 14 in Willmar/Hutchinson.  Students bring experience from work with ambulance squads, fire departments, the Hennepin Regional Poison Center, and the military; two students from Minneapolis are driving to the Ridgewater site to participate.   Read more about the HCMC/Ridgewater paramedic program and view more paramedic program photos in the Hennepin EMS Facebook album.

What do the students say?

Here are some students’ comments about what they wanted from the program and what they particularly appreciate:

“I wanted to train with the best of the best medics.”

“I wanted to ride with the busiest EMS service in the state.”

“This program has rotations that other programs don’t have, like the Burn Unit.  When I rotated there, I assisted nurses in changing dressings, checking on patients and helped the the Burn Team.”

“(I like) the clinical rotations.  I didn’t expect to be doing all of these different shifts.   It’s a good experience to have access to such a broad range of medical contexts.  And it’s helpful to see where the patients will go after we leave them in the ER.”

“(I appreciate) the diversity of the clinical rotations, and the fact that physicians talk to us, educate us, take time to teach us…the opportunity to see all the facets of the hospital, to be at the heart of things, and work side by side with people.”

“(I appreciate) the ambulance rides with preceptors.  We get to see everything and have lots of opportunities.”

“I had never seen a burn patient, so having the chance to rotate through the Burn Center gave me exposure to it.  I will be more prepared.  We scrub in and assist in the Burn Center.”

“I really like psych. I appreciated Acute Psychiatric Services, which is unique in the state.”

“(I like) being in a teaching hospital, where there are students of various types.”

“(I appreciate) the amount of experience we get to draw on and the variety of calls and locations”

“The program shows you what’s involved in being a metro medic versus an outstate medic.”

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