Military clinicians often arrive at deployment locations only having a few days to assume full medical treatment capabilities. British medical teams assuming control of in-theater ROLE III facilities have been known to train in an identical medical environment prior to their arrival.  U.S. medical teams attempt this practice as well, but simulated training environments frequently fail to accurately and realistically recreate the range and multitude of deployable settings/scenarios in which clinicians actually find themselves. Immersive virtual reality (IVR) can fill this gap by providing a high-fidelity, realistic experience which enhances task performance by creating a sense of presence and fully engaging spatial memory. (1,2)

Medical and traumatic emergencies can be intimidating and stressful.  This is especially true for early-career medical personnel practicing outside their primary specialty in austere, poorly resourced settings. Combat potentiates stressors through a myriad of emotional, cognitive, and physical demands. (3-6) Training providers to respond effectively to medical emergencies before being confronted with a real scenario is limited by unnatural or high cost training modalities which fail to realistically replicate the stress and gravity of real-world trauma management. Opportunities to perform critical procedures and cardinal cases, such as managing a complex trauma, are often limited in small garrison settings. Adding combat elements and stressors to training is even more challenging. Research shows that presenting individuals with realistic and stressful scenarios, in a safe, controlled environment, can optimize performance and potentially decrease the risk of psychological trauma when the event is experienced again.(6)

Deployment experience is extremely heterogeneous and degradation of skills and loss of proficiency can occur for healthcare workers who may spend months with sparse, intermittent patient contact. Currently, military medical leaders are developing individual critical task lists that will require providers to annually complete a designated number of procedures in order to fulfill Army readiness requirements. Achieving the projected quantities of these procedures will be challenging for many providers due to existing practice setting limitations. Simulation training’s evolution over the past decade has allowed it to become a proven and effective education modality for medical personnel of all levels to learn and sustain interpersonal and technical competencies.(7-11) SIM training, despite significant progress, still has limitations which include the need for space, prohibitive equipment costs, and requisite skilled personnel to operate the devices and run the scenarios. Virtual reality offers a unique portable solution to provide independent, asynchronous medical training in resource-limited garrison and deployment settings, using only a laptop and headset. 

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