High-fidelity medical simulation training is one of the few evidence-based interventions demonstrated to reduce medical errors and improve trainee readiness for medical techniques, tactics, and procedures. However, limitations of traditional Manikin-based simulation limit immersive simulation capabilities for the prehospital setting, as Manikins are also strictly limited in their capability to represent actual casualties and the psychoenvironmental characteristics of battlefield environments. In this paper, we report our adaptation of a commercially available civilian virtual reality (VR) medical simulation training platform for use in a novel curriculum for medical sustainment training of USAF Pararescuemen and other special forces personnel.

First, an interprofessional framework for virtual reality scenario concept development, specification, and engineering documentation is outlined, providing a roadmap for agile, interactive development of effective simulation training curricula. Second, a conceptual and practical framework for the specification of fully immersive deployed medicine simulation scenarios is described, including states, triggers, transitions, animations, medical assets, and other requisite information, with a model for integrating applicable tactics, techniques, and protocols from JTS Clinical Practice Guidelines and other knowledge sources.

Finally, the results of research effort will be described in detail, including detail about the 26 implemented scenarios (ACS, airway burn, anaphylaxis, asthma exacerbation, blast injury, blunt trauma, concussion, crush injury, cutaneous abscess, dive/gas embolism, extrication, lateral canthotomy, heat stroke, helicopter transport, HAPE, lumbar strain, mass casualty, meningitis, military working dog, pediatric abdominal pain, penetrating trauma, gas exposure, prolonged field care, seizure, TBI, and ventilator training), approaches to achieving full immersiveness in the virtual setting, environmental and battlefield realism modifiers and distractors, enemy action and non-player characters, and implemented interventions and procedures appropriate to the TCCC Tier 4 skillset. The results of initial testing and evaluation will be described, and a review of current ongoing continued research and evaluation efforts of the project will be provided.

Keywords
AUGMENTED AND VIRTUAL REALITY (AR/VR),BEST PRACTICES,MEDICAL MODELING AND SIMULATION,SIMULATIONS,TRAINING

Additional Keywords