title: Using immersive simulation for training first responders for mass casualty incidents.
abstract: OBJECTIVE
  A descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event.
  
  
  METHODS
  Utilizing a virtual reality cave automatic virtual environment (CAVE) and high-fidelity human patient simulator (HPS), a group of experts modeled a football stadium that experienced a terrorist explosion during a football game. Avatars (virtual patients) were developed by expert consensus that demonstrated a spectrum of injuries ranging from death to minor lacerations. A group of paramedics was assessed by observation for decisions made and action taken. A critical action checklist was created and used for direct observation and viewing videotaped recordings.
  
  
  RESULTS
  Of the 12 participants, only 35.7% identified the type of incident they encountered. None identified a secondary device that was easily visible. All participants were enthusiastic about the simulation and provided valuable comments and insights.
  
  
  CONCLUSIONS
  Learner feedback and expert performance review suggests that immersive training in a virtual environment has the potential to be a powerful tool to train first responders for high-acuity, low-frequency events, such as a terrorist attack.
authors.affiliation: Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA. wwilk@umich.edu
authors.forename: William
authors.initials: W
authors.lastname: Wilkerson
authors.forename: Dan
authors.initials: D
authors.lastname: Avstreih
authors.forename: Larry
authors.initials: L
authors.lastname: Gruppen
authors.forename: Klaus-Peter
authors.initials: KP
authors.lastname: Beier
authors.forename: James
authors.initials: J
authors.lastname: Woolliscroft
mesh_terms: D003198:Computer Simulation; D004189:Disaster Planning / Q000458:organization & administration; D004496:Education, Continuing / Q000458:organization & administration; D004632:Emergency Medical Services / Q000458:organization & administration*; D004634:Emergency Medical Technicians / Q000193:education*; D005246:Feedback; D006801:Humans; D054527:Mass Casualty Incidents; D016544:Patient Simulation; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods; D014584:User-Computer Interface