On June 21, 2022, the Simulation in Motion–Iowa (SIM-IA) program was launched with an official ribbon cutting at the Capitol in Des Moines. “SIM-IA is like nothing the state has ever seen,” University of Iowa College of Nursing Dean Julie Zerwic said at the event. “Three custom-built mobile simulation units will soon be traversing the rural roads of Iowa, bringing high-quality, real-world clinical simulation education to healthcare providers. Whether the providers are in Adams County or the town of Zearing, SIM-IA allows us to bring this education to their doorstep.”
Less than three years later, the program has educated more than 14,000 people around the state, including emergency medical services (EMS) providers, high school students, quarry workers, nurses, long term care workers, and athletic trainers. In May 2025, at a training with Chickasaw County EMS in New Hampton, Iowa, the goal of providing education in every one of Iowa’s 99 counties was completed.
“Reaching the 99th county in Iowa is a testament to the dedication and hard work of the SIM-IA team,” said Brian Rechkemmer, program director. “This milestone underscores our commitment to enhancing emergency medical training and ensuring that every community in Iowa has access to life-saving education and resources.”
A 2019 needs assessment found that many EMS and critical access hospitals in Iowa had little to no continuing education (CE) budget. As a result, most of their CE opportunities were lectures or computer-based review, not the hands-on, interactive learning or simulation-based education providers indicated they needed.
SIM-IA’s program design was informed by the needs assessment, and the hands-on simulation training is provided at no cost to EMS and critical access hospitals. The program was initially funded by a five-year, $8 million grant from The Leona M. and Harry B. Helmsley Charitable Trust, and now relies on grants, philanthropic support, and a newly established endowment to ensure it remains accessible.
The program has been met with enthusiasm throughout the state. In bringing this education to the providers’ doorstep, whole departments can receive the same education while maintaining availability to cover emergencies within their community. SIM-IA also offers an invaluable opportunity for rural providers to practice rarely utilized skills in a non-emergent environment and be prepared when a situation arises.
“This opportunity enhances the readiness of our EMS personnel by providing a safe environment to practice critical life-saving interventions,” Fire Training Captain Thad White of Indianola, a central Iowa town of about 16,000, said after the fire department hosted SIM-IA this spring. “It ensures our team is prepared to deliver the highest level of care when minutes matter most.”
The enthusiasm can be concretely seen in program data. Between June 2022 and June 2025, SIM-IA delivered 3,189 education hours to 14,456 people at 759 training events. Partnerships have been established with Sioux City Fire and Des Moines Fire to house the western and central trucks, respectively, and the program employs eight full-time and 29 part-time people. Together, the three trucks have traversed more than 98,500 miles these last three years—equivalent to nearly three trips around the world.
As the reputation of and appreciation for SIM-IA has grown around the state, it has also gained recognition more broadly. Jacinda Bunch, PhD, RN, SANE-A, NREMT, SIM-IA senior advisor and College of Nursing associate clinical professor, has been invited to present about the program at conferences across the country, and papers have been published about the project in national journals such as Nurse Leader. The model was recently named a 2025 American Academy of Nursing Edge Runner, a prestigious recognition of nurse-designed models of care that was given to just five programs this year.
Additional recognition of the program’s importance and success has come in the form of operational support. SIM-IA recently received $600,000 from the Bedford Falls Foundation-DAF and $5.3 million from The Wellmark Foundation to continue bringing high-quality continuing education to rural Iowa communities.
“Wellmark believes that where you live should not determine the quality of care you receive,” said Laura Jackson, executive vice president of health improvement at Wellmark and chair of The Wellmark Foundation. “Knowing SIM-IA addresses many health care needs across rural Iowa, we are excited to partner with the UI College of Nursing to broaden their ongoing program.”
SIM-IA’s partnership with The Wellmark Foundation will ensure that over the next five years first responders and other health care professionals in Iowa’s 86 rural and urban-mixed Iowa counties receive training at no cost at least twice per year, with one session focused on maternal health.
SIM-IA is a unique, innovative, and highly regarded program. Most importantly, though, it is effective and makes a difference in communities like Clarence, Iowa.
On Oct. 5, 2022, the ambulance service in the small, rural town of Clarence, Iowa, hosted a SIM-IA training. One of the scenarios in their training was a pediatric seizure. On Oct. 7, 2022, Clarence Ambulance was dispatched for a pediatric seizure patient who was unresponsive and not breathing.
“We are so thankful for the opportunity to train on skills in a realistic setting that refresh us to this type of call,” they shared on social media. “Our patient, due in part to the recent hands-on training that our crew received with [SIM-IA], had a positive outcome as our crew was able to act quickly and efficiently.”
SIM-IA was launched and supported for the first five years through a generous grant from the Leona M. and Harry B. Helmsley Charitable Trust. The grant funded program development, three custom mobile simulation units, simulation equipment for each unit, and program support. Without the Trust’s vision and investment, SIM-IA would not be the outstanding program it is today.
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