Problem: few training strategies show a measurable change in team performance. High fidelity  simulation has power but is expensive with limited scope.

Background: clinical training now focuses on teams. Small communities cannot lose their whole team to a central training session. Expert trainers soon burn out if expected to travel wide and often.

Approach: using a hybrid approach, combining local and central skillsets, we have successfully created virtual scenarios, with online support, which challenge the decision-making and collaborative performance of remotely sited teams.

Mobile simulation training is not new. Our approach captures the key learning points in a design that is sustainable, affordable and flexible, without burdening the scenarios with unnecessary, costly gadgets. Performance measures, captured both during training and in post-session clinical practice in a Learning Record Store, can be combined with health service metrics from PLP so that short and long term effects can be tracked.

This approach can be applied to any team-based learning but is most effective when turned on local problem areas, with community-specific input. It has been used to explore issues such as chronic pain, narcotic prescribing, mental health counseling, adverse childhood events, and team-focused crew-resource-management.