Maximizing operational medical personnel readiness for Large Scale Combat Operations will require extensive training for austere resuscitative and surgical care (ASRC) teams, who must maintain clinical and tactical expertise across an ever-changing spectrum of techniques, tactics, and protocols. Traditional simulators used for ASRC training, such as manikins, often struggle to stay up to date with cutting edge medicine and provide sufficient repeatability due to the time and expense of developing, deploying, and modifying training simulations. As technology advances, virtual reality (VR) simulation has emerged as another possible option for trauma team training. This modality has the potential to reduce cost of training, allow for teams to train in geographically separated areas, and for training to happen between teams that may accept the patients in the continuum of care. Early studies suggest that VR simulation is an effective means of training, but there is no current evidence comparing its practical use for team-based ASRC training. This paper reports on a training and evaluation study of a recently-developed VR curriculum for advanced resuscitative care. First, the simulation curriculum will be described, detailing the learning objectives, techniques, tactics, and protocol coverage, and usability design considerations identified through a capability gap analysis with ASRC practitioners. The paper then outlines study hypotheses of evaluating immersion, usability, and efficacy as they pertain to ASRC training for both clinical and team-based learning objectives, as well as corresponding evaluation methodology detailing participant demographics, simulation study protocol, and survey components. The paper then reports the results of the evaluation and an analysis of the VR curriculum to meet educational objectives, alongside practical considerations for implementing VR in current ASRC training paradigms, establishing evidence for this novel simulation technology to be used for operational medicine education and training. 

Keywords
AUGMENTED AND VIRTUAL REALITY (AR/VR);COMBAT CASUALTY CARE;COMBAT TRAUMA;MEDICAL MODELING AND SIMULATION;TEAM TRAINING

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