Emergency preparedness in the 21st century: training and preparation modules in virtual environments.

OBJECTIVES To determine the feasibility of evidence-based design and use of low-cost virtual world environments for preparation and training in multi-agency, multi-site, major incident response. METHODS A prospective cohort feasibility study was carried out. One pre-hospital, and two in-hospital major incident scenarios, were created in an accessible virtual world environment. 23 pre-hospital and hospital-based clinicians each took part in one of three linked major incident scenarios: a pre-hospital bomb blast site, focusing on the roles of the team leader and triage person; a blast casualty in a resuscitation room, focusing on the role of the trauma team leader; a hospital command and control scenario focusing on the role of the clinical major incident co-ordinator/silver commander. Participants supplied both quantitative and qualitative feedback. RESULTS Using a systematic, evidence-based approach, three scenarios were successfully developed and tested using low-cost virtual worlds (Second Life and OpenSimulator). All scenarios were run to completion. 95% of participants expressed a desire to use virtual environments for future training and preparation. Pre-hospital responders felt that the immersive virtual environment enabled training in surroundings that would be inaccessible in real-life. CONCLUSIONS The feasibility and face/content validity of using low-cost virtual worlds for multi-agency major incident simulation has been established. Major incident planners and trainers should explore utilising this technology as an adjunct to existing methodologies. Future work will involve development of robust assessment metrics.