• William Wilkerson, Dan Avstreih, Larry Gruppen, Klaus-Peter Beier, and James Woolliscroft.
• Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA. wwilk@umich.edu
• Acad Emerg Med. 2008 Nov 1;15(11):1152-9.

ObjectivesA descriptive study was performed to better understand the possible utility of immersive virtual reality simulation for training first responders in a mass casualty event.MethodsUtilizing 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.ResultsOf 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.ConclusionsLearner 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.

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