Stottler Henke Advances Training of Healthcare Professionals with New Intelligent Tutoring Systems

Simulation-based systems will help EMTs practice emergency response
and train medical teams to handle fallout from accidents or terrorist attacks

SAN MATEO, Calif., March 6, 2006 – Stottler Henke Associates, Inc. ( has won two contracts to develop simulation-based intelligent tutoring systems (ITS) that will provide automated instruction and feedback to help healthcare professionals improve their decision-making in various emergency situations. The ITSs are funded by branches of the U.S. military, but have important potential civilian applications. One is designed for use by paramedics and emergency medical technicians (EMTs); the other is to train hospital medical teams to correctly assess and respond to terrorist attacks that employ chemical, biological, or radiological (CBR) weapons.

Development of the CBR ITS, dubbed METTLE (Medical Emergency Team Tutored Learning Environment), is funded by a $750,000 contract awarded to Stottler Henke by the Office of the Secretary of Defense and administered by the U.S. Army’s Telemedicine & Advanced Technology Research Center ( at Fort Detrick, Maryland. The system is intended for deployment at military training venues, civilian medical schools and medical continuing education.

METTLE will focus on high-level decision making skills training, with an emphasis on how teams of medical professionals interact. The simulated scenarios will address diagnosis and treatment of patients, and the institutional preparation and response of hospitals and other healthcare facilities in a CBR situation.

Unlike conventional simulators, METTLE allows the student to “converse” with simulated team members. As an ITS, the system also offers a tutoring dialog with the student both during and after exercises.

The first CBR scenario Stottler Henke is creating for METTLE depicts the covert release of anthrax spores in a civilian urban setting. The program simulates a hospital emergency department as patients arrive presenting various symptoms to be diagnosed by the student “player.” One student at a time will play; all other team members will be simulated by the ITS. The ITS runs on a standard PC, and the student “player” converses with simulated team members via natural language. The “player” will be able to check the condition of patients over several days and consult with other hospital officials to devise a course of action, which the ITS will then evaluate for appropriateness. Subject matter content for METTLE is being provided by emergency room doctors at hospitals in the Boston area.

The paramedic training ITS, called Adapt MD, is funded by the U.S. Air Force Research Laboratory ( through another $750,000 contract. In a market dominated by high- cost, mannequin-based simulators requiring significant instructor involvement, Adapt MD represents a low-cost, desktop PC-based simulation environment that requires little or no instructor facilitation.

Adapt MD offers students a virtual training environment, accessible through a standard Web browser interface. A student can engage in a simulated emergency and must ascertain who is suffering from what, the priorities for medical attention, and the appropriate course of immediate action or treatment. In one training scenario, for instance, paramedics arrive at a home where a child was accidentally run over by a car in the driveway. The student must assess the situation and perform actions necessary to ensure scene safety, evaluate the condition of people in the scene, and stabilize them for transport. The simulation provides hints and feedback to guide the student. By offering automated assessment, coaching and performance review, Adapt MD enables students to train independently on their own time.

Additionally, Adapt MD features an integrated authoring capability so that instructors can easily create simulated scenarios for student exercises and automated tutoring feedback, all without programming. This capability to completely customize the simulations to reflect the user organization’s specific protocols and equipment is provided through Stottler Henke’s embedded Task Tutor Toolkit™ product.

A test version of Adapt MD is expected to be ready for deployment this month. Several fire departments in Oregon already have expressed interest in the system, and have helped Stottler Henke design the simulation system and initial training scenarios.

“We’re excited to apply our training systems expertise to the healthcare domain, where basic and continuing education is such a vital element of quality of service and ultimate success,” said Dick Stottler, president of Stottler Henke Associates. “Since improving our nation’s medical emergency readiness is both a healthcare and national security priority, it makes sense to apply advanced technologies to multiply the reach and effectiveness of the training available to healthcare professionals, which is precisely what these ITSs are designed to accomplish.”

Founded in 1988, Stottler Henke Associates, Inc. applies artificial intelligence and other advanced software technologies to solve problems that defy solution using traditional approaches. The company delivers intelligent software solutions for education and training, planning and scheduling, knowledge management and discovery, decision support, and software development. Stottler Henke’s clients include manufacturers, retailers, educational media companies and government agencies. Stottler Henke received a 2004 “Brandon Hall Excellence in Learning” award for innovative technology. For the past three consecutive years, Stottler Henke was named one of the “top 100″ companies making a significant impact on the military training industry by Military Training Technology magazine, and in 2005 received a Blue Ribbon recognizing it as a company that leads the industry in innovation.

March 6, 2006