Virtual Reality-Based Manikin Simulation Training

Introduction: Simulation training is a required component of medical education at all levels. The equipment, its setup and upkeep can be labor-intensive, expensive, and require large amounts of physical storage. In many military settings, careful consideration must be taken in regards to equipment requirements as space is often at a premium. In addition, many military settings involve geographic isolation from personnel and materials required for skills sustainment training. This can result in large costs as personnel must leave their current station for higher resource settings where training can be facilitated. Virtual reality is a relatively new training modality which requires much less storage space, cost, and time for setup and breakdown. Travel costs can also be minimized by allowing members to participate all across the world. Using virtual reality as a medium, we create a manikin-based simulation training environment.

Methods: Utilizing input from medical professionals from all levels, we created a virtual training manikin to teach medical skills ranging from basic to Physician-level case content. The creation process involved subject-matter expert input from Emergency Medicine physicians as well as content creators with backgrounds in Nursing, prehospital medicine, and military medicine. Recommendations were provided in regards to critical scenarios, their management, and the expected physiological, lab, and imaging changes that would accompany each process. Content created includes (but is not limited to) cardiac arrest, pulmonary embolism, pneumonia, asthma, as well as various cardiac dysrhythmias. Proper interventions lead to appropriate physiologic responses as well as vital sign changes. Utilizing moderator-based controls, an instructor can decide the physiologic process they wish a patient to have. Vital signs, patient physical exam findings, as well as mental status can be altered as well to give the impression of clinical improvement or possibly deterioration. Additionally, moderators can choose to include image interpretations of various x-rays, as well as ultrasound and some Computed Tomography studies (both normal and abnormal options) to include image interpretation into the learner decision-making process.

Results: By utilizing a virtual space, training evolutions can be moderated by subject matter experts for anywhere in the world, eliminating the need for transport of either learner or instructor. Alternatively, tool functionality allows for multiple learners to participate in the same case together, facilitating unit cohesion and teamwork.

Conclusion: Virtual reality-based simulation training allows a large breadth of training options for a fraction of the cost of a traditional mannequin, while offering added benefits of decreased cost and storage space, and increased immersion and accessibility.