Introduction: There has been a rapid, demonstrated increase in utilization and implementation of virtual reality (VR) in medical simulation training pipelines across civilian and military organizations, largely due to the advantages over traditional simulation. The decreased materials and personnel costs, decreased space requirements, minimal medical waste, and increased flexibility of VR are particularly useful advantages for training military medical personnel, who must maintain readiness across an ever-changing skill set with limited access to resources. For example, advancements in advanced resuscitative care have shown that Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) can successfully control bleeding in austere environments and save warfighter lives. This nascent, highly intricate procedure has proven a unique readiness challenge given its infrequent use, expensive consumable materials, and high-risk nature. We describe a novel curriculum created that allows for VR training in advanced resuscitative care utilizing the REBOA procedure.
Description: Through the combined effort of medical subject matter experts, scenario design specialists, and program developers, a REBOA procedure was developed on a commercial VR medical simulation platform to enable stepwise completion of this high-risk, low-volume procedure. This approach enforced appropriate procedural order of events from start to finish. During each stage of the procedure, physiological and imaging-based changes occur to allow real-time feedback to learners that illustrate the success or failure of each step and overall procedure. In addition, a comprehensive VR curriculum was designed to span the medical decision-making required during advanced resuscitative care. The patient encounters include high-risk severe military-related traumatic disease patterns such as difficult/bloody airways, junctional hemorrhage, amputations. Several scenarios also require prolonged casualty care. Each patient requires multiple interventions to achieve stabilization. Depending on the clinical scenario, these can include intubation, cricothyrotomy, tourniquet placement/replacement, blood product transfusion or REBOA, and, in some cases, specific medication administration or intervention reassessments. Upon completion of each scenario, a feedback form is automatically generated that details relevant critical actions, whether or not they were performed, and time stamps regarding each step taken in patient care.
Discussion: By creating an advanced resuscitation training curriculum utilizing the REBOA procedure, we allow future learners to increase their understanding of these instruments and their function in a setting that can be run countless times using minimal space and wasting essentially zero training equipment. With easier access to REBOA training, medical providers will be better equipped to handle situations that require this specialized procedure.
@inproceedings{poppe2024design,
author = {Poppe, M. A. and Barrie, M. and Patel, N. and Dorsch, J. and Ribeira, J. and Weiss, T. and Mallon, P. and Carr, N. and Polson, J. and Ribeira, R. J. and Sarma, K. V.},
title = {Design and Implementation of a Novel Virtual Reality Medical Curriculum Utilizing Resuscitative Endoscopic Balloon Occlusion of the Aorta (REBOA)},
booktitle = {Society for Simulation in Europe Annual Meeting},
year = {2024},
}