77 Virtual Reality Trauma Simulation: An Immersive Method to Enhance Medical Personnel Training and Readiness

Abstract

Immersive virtual reality (IVR) can be highly effective as a medical simulation training platform. Given recent advancements this technology has become increasingly portable and visually realistic. While IVR technology appears to hold promise, there is a great deal to learn about the best way to functionally develop, implement, and share these training resources. Several groups have created models that recreate current simulation lab environments with instructor input. While these systems increase training opportunities, decrease equipment needs, and offer broad potential, they still require a skilled trainer to ‘prompt the system.’ Removing this limitation seems like a potential way to increase scalability. We are currently in the process of creating, to our knowledge, the only simulator that would offer immediate autonomous feedback to users through both real-time patient physiologic responses and overall grading. We created a working group of 10 active duty or former military emergency physicians and 2 technical experts. We hosted 15 meetings to facilitate the development process. The program was developed with financial support from the Telemedicine and Advanced Technology Research Center (TATRC), through the primary vendor Exonicus, Inc, with support from Anatomy Next Inc, and Kitware, Inc. Development was completed using an agile project management style, which allowed our team to review progress and provide immediate feedback on previous milestones throughout its completion. The working group completed the resulting 4 simulation scenarios to evaluate perceived realism and training potential. Finally, while one member of the team was deployed, testing of the technology platform off the network in a deployed role 3/tent environment was conducted. Upon completion we created four IVR scenarios based on the highest mortality battlefield injuries: hemorrhage, tension pneumothorax, and airway obstruction. The working group unanimously indicated a high level of realism and potential training usefulness. Throughout this process there have been a number of lessons learned and we present those here to show what we have created as well as provide guidance to others creating IVR training solutions. Our team developed trauma scenarios that, to our knowledge, are the only IVR trauma scenarios to run autonomously without instructor input. Furthermore, we provide a potential template for the creation of future autonomous IVR training programs. This framework may offer a dynamic starting point as more teams seek to leverage the capabilities IVR offers.