title: Virtual reality triage training provides a viable solution for disaster-preparedness.
abstract: OBJECTIVE
  The objective of this study was to compare the relative impact of two simulation-based methods for training emergency medicine (EM) residents in disaster triage using the Simple Triage and Rapid Treatment (START) algorithm, full-immersion virtual reality (VR), and standardized patient (SP) drill. Specifically, are there differences between the triage performances and posttest results of the two groups, and do both methods differentiate between learners of variable experience levels?
  
  
  METHODS
  Fifteen Postgraduate Year 1 (PGY1) to PGY4 EM residents were randomly assigned to two groups: VR or SP. In the VR group, the learners were effectively surrounded by a virtual mass disaster environment projected on four walls, ceiling, and floor and performed triage by interacting with virtual patients in avatar form. The second group performed likewise in a live disaster drill using SP victims. Setting and patient presentations were identical between the two modalities. Resident performance of triage during the drills and knowledge of the START triage algorithm pre/post drill completion were assessed. Analyses included descriptive statistics and measures of association (effect size).
  
  
  RESULTS
  The mean pretest scores were similar between the SP and VR groups. There were no significant differences between the triage performances of the VR and SP groups, but the data showed an effect in favor of the SP group performance on the posttest.
  
  
  CONCLUSIONS
  Virtual reality can provide a feasible alternative for training EM personnel in mass disaster triage, comparing favorably to SP drills. Virtual reality provides flexible, consistent, on-demand training options, using a stable, repeatable platform essential for the development of assessment protocols and performance standards.
authors.affiliation: Department of Medical Education, University of Michigan Medical School, Ann Arbor, MI, USA. pandreat@umich.edu
authors.forename: Pamela B
authors.initials: PB
authors.lastname: Andreatta
authors.forename: Eric
authors.initials: E
authors.lastname: Maslowski
authors.forename: Sean
authors.initials: S
authors.lastname: Petty
authors.forename: Woojin
authors.initials: W
authors.lastname: Shim
authors.forename: Michael
authors.initials: M
authors.lastname: Marsh
authors.forename: Theodore
authors.initials: T
authors.lastname: Hall
authors.forename: Susan
authors.initials: S
authors.lastname: Stern
authors.forename: Jen
authors.initials: J
authors.lastname: Frankel
mesh_terms: D000328:Adult; D003479:Curriculum; D004189:Disaster Planning / Q000458:organization & administration*; D004635:Emergency Medicine / Q000193:education*; D006801:Humans; D007396:Internship and Residency; D054527:Mass Casualty Incidents; D016544:Patient Simulation; D013663:Teaching / Q000379:methods; D014218:Triage / Q000458:organization & administration* / Q000592:standards; D014584:User-Computer Interface