title: Development and evaluation of a trauma decision-making simulator in Oculus virtual reality.
abstract: BACKGROUND
  Consumer-available virtual-reality technology was launched in 2016 with strong foundations in the entertainment-industry. We developed an innovative medical-training simulator on the Oculus™ Gear-VR platform. This novel application was developed utilising internationally recognised Advanced Trauma Life Support (ATLS) principles, requiring decision-making skills for critically-injured virtual-patients.
  
  
  METHODS
  Participants were recruited in June, 2016 at a single-centre trauma-course (ATLS, Leinster, Ireland) and trialled the platform. Simulator performances were correlated with individual expertise and course-performance measures. A post-intervention questionnaire relating to validity-aspects was completed.
  
  
  RESULTS
  Eighteen(81.8%) eligible-candidates and eleven(84.6%) course-instructors voluntarily participated. The survey-responders mean-age was 38.9(±11.0) years with 80.8% male predominance. The instructor-group caused significantly less fatal-errors (p < 0.050) and proportions of incorrect-decisions (p < 0.050). The VR-hardware and trauma-application's mean ratings were 5.09 and 5.04 out of 7 respectively. Participants reported it was an enjoyable method of learning (median-6.0), the learning platform of choice (median-5.0) and a cost-effective training tool (median-5.0).
  
  
  CONCLUSIONS
  Our research has demonstrated evidence of validity-criteria for a concept application on virtual-reality headsets. We believe that virtual-reality technology is a viable platform for medical-simulation into the future.
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland. Electronic address: cuanharrington@rcsi.ie.
authors.forename: Cuan M
authors.initials: CM
authors.lastname: Harrington
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Dara O
authors.initials: DO
authors.lastname: Kavanagh
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Tallaght Hospital, Dublin, Ireland.
authors.forename: John F
authors.initials: JF
authors.lastname: Quinlan
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Donncha
authors.initials: D
authors.lastname: Ryan
authors.affiliation: Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dicker
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Dara
authors.initials: D
authors.lastname: O'Keeffe
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Oscar
authors.initials: O
authors.lastname: Traynor
authors.affiliation: Department of Surgical Affairs, Royal College of Surgeons in Ireland, Ireland.
authors.forename: Sean
authors.initials: S
authors.lastname: Tierney
mesh_terms: D000328:Adult; D061906:Advanced Trauma Life Support Care; D002983:Clinical Competence; D000066491:Clinical Decision-Making / Q000379:methods*; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008875:Middle Aged; D000066908:Simulation Training / Q000379:methods*; D014194:Traumatology / Q000193:education*; D000076142:Virtual Reality; D014947:Wounds and Injuries / Q000628:therapy*
keywords: Simulation; Surgical education; Trauma moulage; Virtual reality