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Immersive Virtual Reality Simulation for Tactical Mass-Casualty Triage: An Observational Study of Usability, Realism,
Kristoffer Lie Eide1, Brad Keating2, Asbjørn Braastad3
1Department of Organisation, Leadership and Management, https://ror.org/02dx4dc92University of Inland Norway, Norway.
Introduction:
Mass casualty incidents (MCIs) in high-risk environments pose major challenges for coordinated emergency response. Training is often infrequent, resource-intensive, and lacks interagency consistency. This study explores the use of Virtual Reality (VR) simulation to train responders in the RAMP triage model across emergency services.
Methods:
An observational qualitative design was used. Sixteen participants from various emergency services engaged in a VR-based MCI scenario involving 26 patients and hazardous conditions. The scenario required rapid RAMP triage based on essential cues (radial pulse and the ability to follow commands). Structured interviews followed, and data were analyzed thematically.
Results:
Three themes emerged: (1) Deficiencies in current training, including inconsistent MCI protocols, lack of guideline familiarity, and limited interagency practice; (2) VR as an effective, low-resource training method enabling repeatable and safe practice-RAMP triage was found intuitive and efficient, even for non-medical personnel; and (3) prerequisites for VR implementation, such as realistic design, technical infrastructure, and stakeholder involvement to support shared understanding.
Conclusion:
VR-based MCI training is a feasible and effective supplement to traditional drills. It enables scalable and flexible skill-building, though it should complement and not replace live exercises.
