A Virtual Reality Training System for the Triage and Stabilization of Head Trauma and Multiple Injury Patients

Abstract : Rapid and effective intervention for medical emergencies sustained on the battlefield, while rendering humanitarian service, or in a chemically/biologically contaminated environment is crucial for saving lives and limiting long-term disability. Inexperienced providers may suffer in performance when faced with limited supplies and the demands of stabilizing casualties never encountered back home in the comparatively resource-rich hospital setting. Head trauma and multiple injury cases are particularly complex to diagnose and treat, requiring the integration and processing of complex multi modal data. In this project, collaborators adapted and merged existing technologies to produce a flexible, modular patient simulation system with both three- dimensional virtual reality and two-dimensional flat screen user interfaces for teaching cognitive assessment and treatment skills. This experiential, problem-based training approach engages the user in a stress-filled, high-fidelity world, providing multiple, tailored learning opportunities within a compressed period of time and without risk. The system simulates both the dynamic State of the patient and the results of user intervention, enabling trainees to watch the virtual patient deteriorate or stabilize as a result of their decision-making speed and accuracy. Systems can be deployed to the field enabling trainees to practice repeatedly until their skills are mastered and to maintain those skills once acquired.

[1]  Reuven R. Levary,et al.  The Use of Simulation in Planning the Transportation of Patients to Hospitals Following a Disaster , 1998, Journal of Medical Systems.

[2]  J O Pentecost,et al.  3D computer modeling of human cardiogenesis. , 1999, Computerized medical imaging and graphics : the official journal of the Computerized Medical Imaging Society.

[3]  D. T. Vernon,et al.  Does problem‐based learning work? A meta‐analysis of evaluative research , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[4]  M J Ackerman,et al.  The Visible Human Project: a resource for education. , 1999, Academic medicine : journal of the Association of American Medical Colleges.

[5]  M. Albanese,et al.  Problem‐based Learning: A Review of Literature on Its Outcomes and Implementation Issues , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[6]  J. Sinacore,et al.  Assessing the semantic content of clinical case presentations: studies of reliability and concurrent validity , 1997, Academic medicine : journal of the Association of American Medical Colleges.

[7]  T. Helling,et al.  The role of early surgical intervention in civilian gunshot wounds to the head. , 1992, The Journal of trauma.

[8]  David G. Haut,et al.  Modeling and Simulation for the New Pacific Community: A USPACOM Perspective , 1994 .

[9]  M N Oğuztöreli,et al.  Modelling and simulation of chemotherapy of haematological and gynaecological cancers. , 1999, IMA journal of mathematics applied in medicine and biology.

[10]  M R Stytz,et al.  A distributed virtual environment prototype for emergency medical procedures training. , 1997, Studies in health technology and informatics.

[11]  D M Kaufman,et al.  Teaching and assessing clinical skills using virtual reality. , 1997, Studies in health technology and informatics.

[12]  J. Rhea,et al.  Tension pneumothorax. , 1982, American family physician.

[13]  Sharon A. Stansfield,et al.  MediSim: a prototype VR system for training medical first responders , 1997, Proceedings. IEEE 1998 Virtual Reality Annual International Symposium (Cat. No.98CB36180).

[14]  Annette L. Sobel,et al.  Biosimmer: A Virtual Reality Simulator for Training First Responders in a BW Scenario , 1998 .

[15]  J. Rethans,et al.  The use of standardized patients in research in general practice. , 1997, Family practice.

[16]  G. Setnik,et al.  Demonstration of high-fidelity simulation team training for emergency medicine. , 1999, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[17]  H. Gerngross,et al.  Computer-assisted training program for simulation of triage, resuscitation, and evacuation of casualties. , 1998, Military medicine.

[18]  F. Miller,et al.  Computer modeling of the pathomechanics of spastic hip dislocation in children. , 1999, Journal of pediatric orthopedics.

[19]  Sharon A. Stansfield A Distributed Virtual Reality Simulation System for Situational Training , 1994, Presence: Teleoperators & Virtual Environments.

[20]  E. W. Morris No , 1923, The Hospital and health review.

[21]  C. Walleck Preventing secondary brain injury. , 1992, AACN clinical issues in critical care nursing.

[22]  D B Raemer,et al.  Computerized realistic simulation: a teaching module for crisis management in radiology. , 1999, AJR. American journal of roentgenology.

[23]  Frank K. Butler,et al.  Naval Special Warfare Computer-Aided Corpsman Training Program (Version 1.0) -Multiple Choice Items. , 1994 .

[24]  R Zajtchuk,et al.  Battlefield trauma care: focus on advanced technology. , 1995, Military medicine.

[25]  D. Gaba,et al.  Assessment of Clinical Performance during Simulated Crises Using Both Technical and Behavioral Ratings , 1998, Anesthesiology.

[26]  S. Cavanaugh Computerized simulation technology for clinical teaching and testing. , 1997, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[27]  K. C. Lun,et al.  Virtual Patients for a Virtual Hospital , 1998, MedInfo.

[28]  L. Pitts,et al.  Predicting survival from head trauma 24 hours after injury: a practical method with therapeutic implications. , 1996, The Journal of trauma.

[29]  P N Kizakevich,et al.  Virtual medical trainer. Patient assessment and trauma care simulator. , 1998, Studies in health technology and informatics.

[30]  L. Berkson Problem‐based learning: have the expectations been met? , 1993, Academic medicine : journal of the Association of American Medical Colleges.

[31]  Henk G. Schmidt,et al.  The psychological basis of problem-based learning , 1985 .

[32]  D. Kolb Experiential Learning: Experience as the Source of Learning and Development , 1983 .

[33]  H. Schwid,et al.  Use of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review. , 1999, Critical care medicine.