Unlike tactical simulators – which leverage open communication protocols such as High Level Architecture (HLA) or Distributed Interactive Simulation (DIS) to permit large-scale, networked training exercises – most medical simulators have been developed using closed or proprietary system architectures. While some open-source medical simulation platforms do exist – including the Open Surgical Simulator (OSS), the BioGears physiology engine, and the Advanced Modular Manikin (AMM) – these platforms are not general purpose. They were each only designed to provide reusable simulation components within very focused content areas.

The lack of “across-the-board” medical simulator interoperability presents numerous challenges for the medical simulation and training community. For example, it is not possible for a simulated patient’s medical condition and physiological parameters to be transferred from one simulator (e.g., a realistic patient manikin) to another (e.g., a Virtual Reality surgical simulator) during a simulated “patient handoff” between Aeromedical Evacuation Crews and the Forward Surgical Team. Similarly, it is not possible to conduct tactical-medical training exercises where weapons automatically register realistic wounding on simulated casualties.

Recognizing these limitations, the Joint Project Manager for Medical Modeling and Simulation (JPMMS) has been leading the effort to develop a next-generation Medical System Training Architecture (MSTA) that will provide an open standard for next-generation medical training, and is currently developing middleware that will permit integration with HLA, DIS, xAPI, STE and related communications protocols. The MSTA effort is one part of a much larger DHA-sponsored effort that seeks to develop a robust Joint Medical System Enterprise (MSE) along the entire continuum of care from Role 1 (point of injury care provided by self and Combat Medics) to Role 4 (long-term treatment and rehabilitation that is provided at a CONUS facility). The purpose of this paper is to define the MSTA project’s vision, goals, approach, current status, future plans, challenges,