Developing a Just-in-Time Refresher Trainer for Advanced Life Support in Austere Regions: Phase II

Early recognition of impending decompensation and appropriate intervention is critical to patient survival. However, military personnel receive limited real-world practice in recognizing and treating impending decompensation in non-military patient populations. Tier 4 medics complete training in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS), yet the skills learned are likely to degrade due to lack of regular use in deployed environments. The ability to recognize the patient’s condition, anticipate future states, and implement treatment for a range of patients and conditions will be increasingly important in the future. The DoD anticipates that future multi-domain and large-scale combat operations against sophisticated adversaries will significantly impact the evacuation of patients to higher levels of care. As a result, it is likely that tactical medial providers will need to treat patients for longer periods of time in resource-constrained environments before transferring them to higher levels of care (i.e., prolonged field care), and have limited access to remote support. Unveil, LLC will team with experienced clinicians and medical simulation experts from the University of Florida in this Phase II STTR to further develop the Trainer for Advanced Life Support in Austere Regions (TALSAR). TALSAR is a standalone training application that uses a combination of didactic learning aids, experiential exercises, and expert model-based performance feedback to deliver refresher training to deployed medics. TALSAR is grounded in theories of learning and expertise and offers advanced augmented reality-based interactions to provide realistic representations of subtle perceptual cues on virtual patients. Furthermore, TALSAR contains readiness assessment measures to provide data about individuals’ level of readiness to address specific conditions in austere, deployed environments. During Phase II, the Unveil-led project team will address four objectives. First, we will develop a TALSAR minimum viable product (MVP). The MVP will be a fully functioning version of TALSAR. Second, we will evaluate the effectiveness of TALSAR training and associated readiness assessment measures. We will conduct a series of studies to evaluate the sensitivity of our readiness assessment measures, the effectiveness of TALSAR training, and the transfer of skills learned in TALSAR to a more realistic simulated patient encounter. Third, the team will develop infrastructure to support long-term expansion of TALSAR. This includes tools to make it easier to create and integrate new training content into TALSAR and foundational work to incorporate machine learning algorithms to provide automated adaptive feedback to people using TALSAR. Fourth, we will develop a plan to integrate TALSAR into existing refresher training in deployed contexts. We will also investigate civilian applications of TALSAR.