Training Effectiveness of a Wide Area Virtual Environment in Medical Simulation.
BACKGROUND
The success of war fighters and medical personnel handling traumatic injuries largely depends on the quality of training they receive before deployment. The purpose of this study was to gauge the utility of a Wide Area Virtual Environment (WAVE) as a training adjunct by comparing and evaluating student performance, measuring sense of realism, and assessing the impact on student satisfaction with their training exposure in an immersive versus a field environment.


METHODS
This comparative prospective cohort study examined the utility of a three-screen WAVE where subjects were immersed in the training environment with medical simulators. Standard field training commenced for the control group subjects. Medical skills, time to completion, and Team Strategies and Tools to Enhance Performance and Patient Safety objective metrics were assessed for each team (n = 94). In addition, self-efficacy questionnaires were collected for each subject (N = 470).


RESULTS
Medical teams received poorer overall team scores (F1,186 = 0.756, P = 0.001), took longer to complete the scenario (F1,186 = 25.15, P = 0.001), and scored lower on The National Registry of Emergency Medical Technicians trauma assessment checklist (F1,186 = 1.13, P = 0.000) in the WAVE versus the field environment. Critical thinking and realism factors within the self-efficacy questionnaires scored higher in the WAVE versus the field [(F1,466 = 8.04, P = 0.005), (F1,465 = 18.57, P = 0.000), and (F1,466 = 53.24, P = 0.000), respectively].


CONCLUSIONS
Environmental and emotional stressors may negatively affect critical thinking and clinical skill performance of medical teams. However, by introducing more advanced simulation trainings with added stressors, students may be able to adapt and overcome barriers to performance found in high-stress environments.
From the Axiom Resource Management, Inc. (G.S.W), Program Manager, Air Force Medical Service Analytics, Air Force Medical Operations Agency, San Antonio, TX DCS Corporation (R.T.), Army Research Laboratory, Aberdeen, MD; and Ministry of Public Health Doha, Qatar. All authors previously worked on a government contract with Air Force Medical Modeling and Simulation Training (AFMMAST).
Grady S
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Rebekah
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Rasha
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D002983:Clinical Competence / Q000592:standards*; D003198:Computer Simulation; D004634:Emergency Medical Technicians; D005260:Female; D006801:Humans; D008297:Male; D010348:Patient Care Team; D015397:Program Evaluation; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014584:User-Computer Interface