November 12, 2021By Lance Baily

Benefits of XR Across SAR & HEMS Healthcare Simulation Training

Extended reality (XR) is becoming an increasingly popular term across healthcare simulation. Involving the use of augmented (AR), virtual (VR), and mixed reality (MR), the technologies have come to meet the myriad of clinical, aviation, and maintenance priorities within Search and Rescue (SAR) and helicopter emergency medical service (HEMS) training. To outline how this practice is coming into play, William Belk, clinical education manager at Air Methods, outlines in the AirMed&Rescue article, “Beyond VR: extended reality across SAR and HEMS training” how the potential of extended reality can meet the needs of SAR and HEMS clinical, aviation, and maintenance training.

Belk begins by highlighting that the use of clinical simulation is not a new concept and that the different branches of XR are well developed and used in consumer and industrial environments. For example, AR can be used to employ smart devices with passthrough vision, VR can immerse a learner in a virtual environment, and MR is often used to combine a virtual reality headset with the physical environment.

As a result of continual advancements in technology, VR technology has dropped in price – helping to practice increase in popularity. According to Belk, the price drop in combination with an explosion of developers has opened the entire industry of XR training at a lower price point than ever before. Leveraging this access, medical simulationits have turned to XR to boost learner performance, as well as increase a facility or institution’s bottom line. According to research published in the Journal of Medical Internet Research in March 2020, knowledge retention that meets or exceeds traditional physical simulation results in cost savings of as much as 83% over manikin-based training.


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Employing this technology, the United States Air Force (USAF) has been using MR cockpits – which combine VR headsets with realistic physical controls – to train pilots for several years. According to Task & Purpose, in 2018, the USAF program, Pilot Training Next, found that the use of virtual reality cut pilot training time in half. The article continues that, a year later, the UK Royal Air Force (RAF) partnered with USAF Pilot Training Next to provide VR training to their recruits, citing the reduction in training time to help combat the military pilot shortage.

Further, the article notes that the Air Force reported reducing pilot training time by 35% while being able to add an additional 15 hours of training. The program, nicknamed “Project Da Vinci,” included 23.5 hours of VR flight training and resulted in learners being able to “hover, taxi, and perform various other helicopter maneuvers unassisted by their instructor pilots on their very first flight” in an actual aircraft.

As XR is an additional tool that can augment education and reduce time on the aircraft, learners can become more prepared for real-world experiences in a controlled environment. Belk puts it simply: Like clinical and aviation training, the technology is already used elsewhere in the aviation industry, so a precedent exists for its use in HEMS.

“XR is already in use throughout the healthcare and aviation industries. The use of smart glasses to improve maintenance and warehouse safety will likely become commonplace within the next decade,” Belk concludes. “With the emerging technology and current market for hiring custom content developers, we will likely see a surge in XR use within HEMS training and operations. The ability to create entire virtual environments has endless potential for clinical, aviation, and maintenance training.


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Examples of XR Clinical Simulation Software



CAE: CAE has used Microsoft HoloLens to design a series of augmented reality programs that project 3D animations on their physical clinical simulation manikins. When paired with their high-fidelity ultrasound trainer Vimedix, the HoloLens shows the user’s internal organs in their correct location. The software can also elevate the organs to float above the body where the learner can manipulate the projection. According to the article, while this application requires the use of specific CAE manikins, the application does highlight the possibility of AR projections that can be custom made to extend the working life of aging patient simulators reducing the cost of repairs and the necessity of replacement.

SimX: SimX is a VR training company based in California. The SimX software platform allows multiple users to be present in the same virtual scenario while physically being thousands of miles apart. This ability to conduct high-fidelity simulations without the need for in-person meetings or travel has an obvious appeal when many organizations are struggling to protect their employees from exposure and navigate travel restrictions.

“The power of VR is that, in theory, it lets you simulate and track almost anything. This is especially true in HEMS, where we can create an immersive scenario requiring the crew to continue caring for a patient while also dealing with a mechanical failure. Outside of VR, this would be difficult, expensive, or impossible to simulate,” Ryan Ribeira, CEO of SimX, said in the article.

FlightSafety International: The US-based training company, FlightSafety International, markets a Mixed Reality Flight program as an economical way to augment pilot training and offer virtual cockpits for both fixed-wing and rotor-wing aircraft. With options geared for both government and civilian operators, these MR offerings are capable of familiarizing pilots in new airframes, training basic procedures, and practicing emergency procedures. Additionally, the hardware can be as simple as a laptop and basic spring-centering controls or as advanced as a full-motion platform and type-specific controls – based on the customer’s needs. All options employ a VR headset to provide the necessary visuals of the cockpit and the aircraft’s surroundings.

More About the Author: William Belk’s professional interests include high-risk obstetrics, serious gaming, 3D printing, and all aspects of healthcare simulation. He serves as the Technical Chair for the AMTC Sim Cup alongside an international team of flight clinicians and educators. He has spoken on the topics of healthcare simulation, serious gaming, and 3D printing at several international conferences, as well as virtually for the Society for Simulation in Healthcare.

Read the Full AirMed&Rescue Article


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