Surgical Perioperative Expeditionary Medical Support Training for Air Force Nursing using Virtual Reality

Under the Air Force's Agile Combat Employment (ACE) framework, medical service nurses must be ready to treat injuries and illnesses in harsh conditions for extended periods, with limited resources and support. The evolving nature of operational medicine, featuring near-peer competition, low-intensity conflict, joint/all-domain operations, and WMD threats, highlights the lack of training resources. This necessitates a renewed emphasis on surgical (perioperative) nursing in non-traditional settings such as makeshift facilities and host nation buildings. Perioperative expeditionary medical support in damage control surgery (DCS) will be crucial in Large Scale Combat Operations (LSCO), where numerous casualties need immediate life-saving interventions. This renewed focus demands enhanced skills, tactics, techniques, and protocols (TTPs), adaptability, and increased problem-solving abilities. Effective and efficient virtual training will ensure operational preparedness and reduce risks to the mission and personnel. Perioperative medical support is a complex mission, requiring training and proficiency across the spectrum of operations and must be deliberately trained and maintained for effectiveness in operational environments. Expert clinical decision-making is required across diverse settings, making pre-deployment training difficult. Current training modalities struggle to simulate the resource-limited settings of an Expeditionary Medical Support (EMEDS) environment. Perioperative expeditionary medical support operations are high-stakes, rare events where virtual reality (VR) simulation will be critical in enhancing complex decision-making capabilities across Air Force and DoD operations. SimX has identified proposed adaptations, including 1) the development of a VR-deployed perioperative expeditionary medical support environment as well as a virtual hardened facility surgical environment with integrated nursing and physician teams, 2) the development and implementation of complete perioperative medical support sets, kits, and outfits as well as relevant medical procedures and TTPs, and 3) the development and implementation of 5 surgical operating room patient scenarios.