The Develop and Validation of the UK Virtual Reality (VR) Medical Trauma Assessment and Training tool

Emergency medical trauma situations are complex, time pressured, and require the coordination of an interdisciplinary team of medical personnel to make appropriate decisions to save lives. Currently in the UK there is a two-day trauma training course that is used in trauma education (ATLS – Advanced Trauma Life Support).  Whilst this programme, and others like it, are important in medical trauma training they do not provide in-situ training.  Simulation training (i.e., with ‘stooge’ patients) can be used as an important compliment to trauma training as it allows trainees to encounter close-to-real-life situations.  Simulation training however is not widespread because it requires a specialist environment and actors to conduct. Where it is provided, the training is expensive, time consuming, and may give inconsistent experiences across trainees. Where trainees are ill-prepared for the simulation, the whole endeavour may produce a poor return on investment. This project aimed to therefore develop and validate a new immersive 360-degree video-based assessment and training tool for medical trauma situations.

Using the principles outlined in the three-level framework of Situation Awareness, we developed a multiple-choice “what happens next” video assessment tool.  This was an immersive virtual reality point-of-view video test with embedded probe questions that targeted an individual’s ability to make predictions (a precursor to decision making) in an emergency trauma situation.  To provide a measure of validity, we investigated how well this tool differentiated performance between experienced and inexperienced trauma personnel, and those without experience in a trauma setting.  We found that experienced personnel outperformed inexperienced and novice personnel, suggesting that this tool may be a successful tool in targeting trauma leader expertise.  As a consequence, this video-based tool has the potential to be used for both assessment and training purposes.

More effective training will lead to better health outcomes. More efficient training will release resources for other purposes within the NHS. We believe that this project can provide both. Combing psychological principles with current VR technologies, as we have done, can provide further options for cost-effective complimentary training and assessment, not just in emergency trauma, but across medical healthcare.

This work was undertaken by a large interdisciplinary team led by Dr Andrew Mackenzie, Dr Mike Vernon, James Myers, Professor David Crundall, Dr Keiko Tsuchiya (Yokohama University) and Dr Frank Coffey (University of Nottingham; Director of DREEAM at Queens Medical Centre, Nottingham).