Veteran’s Day salute: CoMotion Labs member Exonicus’ work on Trauma Simulator in VR enhances military medical personnel training

Exonicus, Inc, a CoMotion Labs member, has been working with the Madigan Army Medical Center’s (MAMC) Emergency Medicine Research Department on a project to create a realistic trauma simulator in immersive virtual reality (IVR).

Similar to a pilot’s flight simulator, the Trauma Simulator is a free-play virtual reality training platform capable of training military medical personnel through dynamic physiologic responsive simulations that allow decision-training without an instructor.  The primary focus was decision- training (i.e., cueing) when to initiate a blood transfusion, place a chest tube, or completing other life-saving procedures such as clearing a patient’s airway.

Exonicus was responsible for the programming of Trauma Simulator. They worked closely with University of Washington School of Medicine Postdoctoral Fellow, Dr. Paul Keire, who was instrumental in the development of the trauma management and anatomy aspects of the product. Additional UW collaboration included School of Medicine’s Dr. Kate Mulligan, School of Dentistry’s Dr. Katherine Rafferty, and Department of Rehabilitation’s Dr. Torey Gilbertson, as well as trauma and burn care specialist Dr. Tam Pham. Trauma Simulator has been endorsed by UW Medicine Center for Research in Simulation Technologies (CREST) and is currently working with UW Neonatal Education & Simulation-based Training Program (NEST).

IVR can be highly effective as a medical simulation training platform. Recent advancements have rendered this technology increasingly portable and visually realistic. The system leverages a highly-responsive, validated physiology simulation (Biogears/Pulse Engine) funded by over $7 million in prior Department of Defense-based research.

Tying interventions and visual output to the physiology engine results in realistic alterations in levels of consciousness and vital signs. It also allows injuries to present and respond to treatment in real-time without instructor input. This highly-responsive simulation, combined with an environment containing 100+ 3D objects to treat the patient (replicated from the Madigan trauma bay), creates a highly interactive and realistic experience.  The system tracks when a learner identifies an injury and their time to critical interventions.  Therefore, the user can practice and receive feedback on advanced trauma life support (ATLS) and tactical combat casualty care (TCCC) repeatedly without an instructor being present.

This IVR system was designed as a scalable solution to allow a wide variety of future case combinations and incorporation into multiple treatment environments. The hardware required is a gaming computer and a Microsoft Mixed Reality headset. The complete setup costs approximately $2000. It can run without an internet connection, and has been utilized in a ROLE III deployed location (tent structure) in Iraq with good functionality.

Plans are underway to expand the project to include a mass casualty event with multiplayer functionality integrated into the training experience. The project is under review by the American College of Surgeons Committee on Trauma, NATO medical training facilities, European Defence Agency and several countries who are evaluating the feasibility of incorporating it into Advanced Trauma Life Support training.


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