Abstract
BACKGROUND: Japan's HEMS (Helicopter Emergency Medical Services) has recently shifted from quantitative expansion to qualitative improvement, highlighting the need for standardizing training and enhancing safety. This study aimed to evaluate a newly developed basic training course that integrates a Medical Trainer (MeTra) simulator, addressing the need for standardized education and improved safety in HEMS operations. METHODS: In total, 208 HEMS professionals (83 doctors, 49 nurses, and 76 operational staff) participated in the revamped course, which combines e-learning, practical discussions, and MeTra simulation. Self-reported questionnaires assessing non-technical (4 items) and technical skills (6 items) using a 5-point Likert scale were administered pre- and post-course. Wilcoxon signed-rank tests evaluated changes in perceived competence. We also measured the MeTra simulator's fidelity and overall course satisfaction. RESULTS: All non-technical and technical skills items improved significantly (p < 0.05), with notable gains in patient management during aircraft malfunction (average increase of 1.49 points) and fire extinguisher use (average increase of 1.11 points). Participants rated the MeTra simulator highly, especially for its enclosed environment, with 91% rating it four or higher, and for its communication system fidelity, with 96% rating it four or higher. Overall course satisfaction was high, with 96% rating it four or higher. Nonetheless, in line with Cook's caution on Kirkpatrick Level 2 data, these findings primarily reflect participants' perceptions rather than objective performance, and no control group was included. CONCLUSIONS: The new basic course incorporating the MeTra simulator may enhance self-reported competencies for diverse HEMS professionals. This standardized education program marks a significant step towards aligning Japan's HEMS training with international standards.