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Cloquet hospital's live birth simulator will help train rural providers

A state-of-the-art live birth simulator at Community Memorial Hospital in Cloquet is tentatively scheduled to open later this winter for rural health care provider training.

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A "baby" is delivered using the RealMom live birth simulator during a demonstration of the device on Monday, Dec. 13, 2021. Contributed / Blue Cross and Blue Shield of Minnesota and Community Memorial Hospital

Community Memorial Hospital in Cloquet is tentatively planning to open its state of the art live birth simulator later this winter, officials said.

The multi-unit device will offer vital obstetrics training for physicians and nurses practicing in rural, low-birth hospitals across the state. It includes a lifelike “RealMom” unit CMH staff has named “Virginia” in which simulated training for any obstetrics situation imaginable can be performed, according to CMH Chief Executive Officer Rick Breuer.

Surgical intervention simulation for emergency cesarean sections, hysterectomies, postpartum hemorrhaging and fetal extraction are performed on a separate unit called the C-Celia Suite. Both devices are interactive and react just as a human would, creating an optimal training tool for medical personnel.

“This is an opportunity to work on something that you hope you never see," Breuer said. “You don’t want to be practicing on re-honing your skills in real-time in a real delivery experience, so what this allows us to do is for physicians and the whole care team, the nurses as well and anyone else in that moment, to step in a controlled setting, set up those routine or complex situations (and) have it all programmed in with the trainer where they know what’s going to happen.”

Research from the University of Minnesota has shed light on the disparities faced in obstetrics care for rural women versus those in urban areas. Expecting mothers in rural areas are 9% more likely to die or face life-threatening situations in childbirth compared to those in urban settings, according to the study.



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A cesarean section training demonstration is shown using the C-Celia simulator on Monday, Dec. 13, 2021. Contributed / Blue Cross and Blue Shield of Minnesota and Community Memorial Hospital

Extended travel times to hospitals for rural, expecting mothers is one of the biggest contributing factors, as the state of Minnesota currently has 29 counties without hospitals that deliver babies. The trend of delivery wards being eliminated in rural hospitals comes as a result of low numbers of babies being delivered to justify their costs.

Physicians at low-birth hospitals often lack the necessary preparation for the myriad complications that can occur during the process of childbirth, further adding to the problem.

“Research has shown that probably the number one reason that OB programs have shut down in rural areas is because the physicians, the nurses — either the ones who are willing to do it, or interested in OB — retire, move away (or) you just don’t have the workforce,” Breuer said.

“Or the ones who are there, say ‘Man I’m just not doing as much of it as what makes me feel comfortable. I need to do more to keep up my skill set, keep up my confidence,' because you never know what’s going to happen at two in the morning with babies,” he added.

Rural health providers will come from all over the state to the “home base” of CMH in Cloquet to use the simulator. The training offered to rural medical personnel will be run by members of the CMH staff who worked extensively with the unit over the summer. The access to the simulator facilitated will help offset costs of the over $200,000 investment.


For its efforts to improve equitable access to care, CMH received the Trailblazer Award from funding-partner Blue Cross Blue Shield of Minnesota, who covered the costs of the equipment and consumables. The Minnesota State Office of Rural Health (SORH) has assisted in the funding required for training on the device, along with the costs of replacement for consumables.

While the device itself is not new, the training opportunity at CMH will be the first of its kind across the country in offering unaffiliated, unrelated medical centers the chance to utilize the state of the art device in a collaborative manner, according to Breuer.

“You might find a large health care provider or a large academic center that has it as a tool and there are people who have access to it — their students, their providers — but we haven’t seen an example like this,” Breuer said.

The Minnesota Board of Nursing requires Registered Nurses to complete 24 contact hours of continuing education over a 24 month period of registration. The training offered by the live birth simulator will count towards those credits for nurses and physicians.

“We’ve already worked through with the Board of Nursing and at the state level to get continuing education credits, basically for our physicians and nurses … Not only are they getting education but they also get those continuing education credits,” Breuer said. “We’re trying to give them a very low cost, very timely, relevant education experience that they can go back and use in their communities.”

The training rollout for rural providers has been delayed several months as a result of the COVID-19 pandemic, as hospitals remain focused on treating the influx of patients suffering from the virus, leaving them unable to send members of their care teams to train on the device.

Breuer hopes that later this winter, if case numbers diminish, the simulator will officially be open for training to rural health care providers.

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