Evaluation of a Virtual Reality Simulator in Sustainment Training

Is there a better way to train our health care personnel to prepare them to operate in a chemical biological environment yet continue to provide for patient care? Could virtual reality (VR) technology be useful in providing a more realistic, hands-on training for skills needed by military medical personnel in their performance of patient/casualty care under chemical-biological conditions? Virtual reality offers a new training modality with the promise of realistic training with many potential savings. VR simulations such as Cath-Sim could provide an alternative to IV arms and moulaged casualties whiling away a day by providing an integrated hands-on experience without ever leaving the classroom.

The purpose of this pilot work was to assess the usefulness, cost-effectiveness, and user satisfaction of the Cath-Sim Intravenous Training System^TM for teaching and achieving competence at IV insertion while in MOPP level 4 for military medical personnel. This pilot project used a randomized controlled trial to examine the efficacy of the Cath-Sim Intravenous Training System^TM virtual reality simulator training upon the success and timely IV insertion under chem-bio conditions (MOPP 4). Participants were stratified and randomized to either VR training or standard model with n = 24 subjects in each group.

Grounded in adult psychomotor learning principles and in the evaluation model developed by Holzemer (1988) from the work of Donabedian (1981) and Chater (1975), participants were tested on both models and then allowed to practice on either the IV arm model or Cath-Sim while at MOPP 4. One week later, participants were again tested on both models. Outcome measures included 1) a computer-generated score sheet measuring time to success and criterion success/non-success, 2) time and success rating from IV insertion on the IV arm model, and 3) satisfaction evaluations completed by the participants. Demographics were collected to provide descriptive data of participants. Descriptive statistics were used to describe the characteristics of the sample. Content analysis was used to evaluate the qualitative aspects of the satisfaction evaluations. Sixty participants enrolled in the study for a final sample of 51 complete data sets (IV arm group n = 25; Cath Sim group n = 26).

No significant difference was found between the IV arm and Cath Sim groups for time to success or success rate (slight edge for IV group). Only sixteen participants were successful on both IV and CS baseline and final testing (12 IV; 8 CS). All sixteen had longer Cath Sim times at the final testing. Fourteen of sixteen improved IV arm times compared to Cath Sim times. The IV group performed better on the Cath Sim final but not significantly different. There were conflicting evaluation scores for recommending one model over the other. Participants felt that there was some benefit to each model depending on user, setting, and purpose. Additional testing and development of virtual reality is warranted as evidenced by the positive features identified by participants, but adaptation of solely this model for chem-bio training is not warranted at this time based upon these findings.

Final report is available on NTRL: https://ntrl.ntis.gov/NTRL/dashboard/searchResults/titleDetail/PB2003102383.xhtml