November 22, 2023By Lance Baily

SimX VALOR Training for Military and Department of Defense

SimX’s Virtual Advancement of Learning for Operational Readiness (VALOR) represents a significant leap forward in the U.S. military’s capacity for Prolonged Casualty Care (PCC) and Austere Resuscitative and Surgical Care (ARSC) training. The integration of Virtual Reality Medical Simulation Training (VR-MST) through SimX’s Virtual Reality Medical Simulation System (VRMSS) is redefining the landscape of medical preparedness for combat situations. This innovative technology delivers an immersive training experience that meticulously replicates the medical complexity and the environmental and psychological stressors of operational combat conditions. This HealthySimulation.com article will discuss the SimX VALOR training.

What is Prolonged Casualty Care (PCC)?

PCC is a facet of military medical operations that involves the provision of extended medical care in an austere environment when evacuation to a higher level of care is delayed or not possible. The concept comes into play when the ‘golden hour’ – the critical period immediately after injury where prompt treatment is crucial to survival – cannot be achieved due to operational or logistical constraints. Under these circumstances, medical personnel must deliver sustained and comprehensive care that could span hours or even days.


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The importance of PCC has grown with the changing nature of military engagements. Modern conflicts may involve asymmetric warfare in remote locations where evacuation resources are limited, or the threat of engagement is too high to allow for immediate medical extraction. Therefore, medics must be prepared to perform not just immediate life-saving interventions but also, intermediate care, pain management, critical care nursing, and even palliative care if necessary.

What is Austere Resuscitative and Surgical Care (ARSC)?

ARSC is an advanced medical capability delivered by small teams with limited resources in austere environments. ARSC bridges gaps in roles of care to enable forward military operations and mitigate risk to the force. Expertise in trauma care is the cornerstone for ARSC teams, as well as foundational trauma training to achieve and sustain the clinical expertise of all team members. Ideally, teams will achieve this expertise by routinely working together in high- volume, high-quality trauma centers to develop trust and fluid team dynamics.ARSC is also vital that team members cross-train on key roles and tasks to maximize the use of limited available resources.

To maximize success, austere teams require a higher state of readiness with greater technical and tactical experience. As shown by VALOR, high-fidelity VR medical simulation can be designed to provide “low occurrence, high consequence” training to improve clinical decision-making and accelerate development while reducing the overall training burden. VR medical simulation addresses a readiness training gap and ensures that teams are prepared to provide ARSC in future operating environments.


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VR Medical Simulation Training from SimX

SimX’s advanced VR simulation training is tailored to meet the needs of elite medical personnel:

  • Complex Skill Sets: The SimX PCC and ARSC scenarios require medics to have a wide range of skills that goes beyond initial trauma care. Simulation training can cover the full spectrum of these skills in a controlled, realistic environment.
  • Decision Making: The PCC and ARSC scenarios often involve making critical decisions with limited resources. Simulations can help medics practice prioritization and decision-making processes that mirror real-world conditions.
  • Psychological Preparedness: The SimX VALOR simulations help accurately represent the stresses of combat and prolonged care to prepare trainees psychologically for the realities of their role. These psychosocial elements are difficult to replicate in traditional training environments.
  • Team Coordination: Military medical teams often must work in tight, coordinated units. The high-fidelity simulations built by SimX help teams practice communication and procedural efficiency in a realistic and high-pressure setting.
  • Equipment Familiarity: PCC and ARSC often utilize specific medical equipment that may not be used in standard care. As built, these VR simulations allow medics to become familiar with novel or rarely used equipment in a risk-free setting.
  • Continuity of Care: PCC training emphasizes the continuity of care over an extended period of time. The SimX PCC simulations can help recreate the passage of time and the evolution of a patient’s condition to train providers in monitoring and adjusting care as needed.
  • Logistical Challenges: The logistics of care in an austere environment include managing supplies, dealing with environmental challenges, and adapting to the limitations of the setting. SimX simulated scenarios can prepare medics for these logistical complexities with the ability to add or remove supplies or equipment with the click of a button.
  • Clinical Judgment: Just like in true emergencies, medics in the SimX PCC and ARSC situations are forced to exercise a high degree of clinical judgment, often with limited guidance. These simulations provide a platform for developing and testing this judgment in complex and evolving situations.

By providing a platform that immerses medics in realistic and diverse casualty care scenarios, SimX enables the practice of vital medical procedures, decision-making under duress, and the management of care over time, all within the challenging context that military medics may face in the field. This level of preparation is essential to ensuring that military medical personnel are fully equipped to deliver the highest standard of care in any environment – ultimately saving lives and enhances mission success.

Revolutionizing Readiness for Today’s Service Members

SimX’s VRMSS–developed in collaboration with stakeholders from the U.S. Air Force SpecialOperations Command (AFSOC)–has been rigorously tested and implemented to ensure that military medical personnel are equipped with the highest level of operational readiness. The system provides a comprehensive VR solution that spans the full continuum of care from the point of injury to Role 4 medical treatment facilities. The VALOR program stands out on the ability to emulate the multifaceted nature of combat casualty care, inclusive of the nuanced psychological and environmental factors that impact medical interventions in the field.

The SimX VRMSS boasts over 200 casualty care scenarios across immersive environments, offering a depth of medical realism reflective of real-world deployed medicine. The scenarios cover the breadth of Tactical Combat Casualty Care (TCCC), operationalized in more than 45 Department of Defense (DoD) installations globally. This curriculum is the product of a synergistic collaboration between SimX’s medical education experts and a dedicated team of active-duty medics, nurses, physicians, and educators from the U.S. Air Force. Starting with the inception of each case, this combined team ensures that the virtual scenarios maintain high standards of realism throughout their development and deployment.

These visionary simulations are designed to challenge learners in high-pressure situations that mirror combat conditions, such as treating multiple casualties within a triage tent under heavy fire or providing medical care in a helicopter while coordinating a patient handoff. The “train as we fight” approach is crucial to the learning process and directly enhances the skills learned in a controlled classroom environment, as these classroom skills far too often do not translate directly to the chaotic and unpredictable nature of a battlefield.

The VALOR Curriculum and Beyond

The VALOR curriculum, launched with a $12 million research initiative in 2020, seeks to enrich the VRMSS with scenarios and functionality tailored to meet the evolving demands of modern military operations. This program underscores the Department of Defense’s recognition of the need for a novel approach to maintain readiness in the face of potential high-casualty conflicts. The initial VALOR CORE curriculum has been actively adopted for training purposes across AFSOC, illustrating its immediate impact and utility.

The program’s VR curricula extend across the various phases of TCCC, addressing a spectrum of medical situations, from small unit care to incidents involving weapons of mass destruction and aeromedical evacuations. The content is continuously updated in collaboration with DoD personnel, ensuring relevance and responsiveness to the changing needs of military medical training.

Cross-Team and Non-Collocated Training

A key innovation of the SimX system is the ability to conduct cross-team training. This cutting- edge technology allows multiple teams to simultaneously participate in a coordinated virtual simulation. These types of features enable Warfighters to integrate combat casualty care training across different roles; thus, SimX helps foster seamless communication, patient handoffs, and the continuation of interventions throughout the continuum of care.

SimX has also pioneered non-collocated training, which allows for the integration of multiple teams or providers into the same virtual scenario- regardless of their geographic locations. This training modality enables global casualty care responders to train together as a team before actual deployment. In comparison to traditional training modalities, such as manikin-based or live exercise simulations that necessitate the physical co-location of all participants, the SimX virtual solution offers a significant advancement in cost and efficacy. SimX enables more frequent and practical collective training sessions, with the added advantage of logistical convenience.




View the HealthySimulation.com LEARN CE/CME Platform Webinar How the SimX Virtual Reality Platform is Disrupting the Clinical Training Landscape to learn more!


Sustaining Operational Readiness and Future Implications

The implementation of SimX’s VRMSS and the VALOR curriculum is pivotal for maintaining operational readiness in combat medicine. As military operations become increasingly complex, so does the knowledge, skills, and abilities required for effective medical response. SimX’s evolving library of virtual simulation scenarios is critical in upholding the high standards of training expected within the military. SimX’s VRMSS and VALOR address the true needs of learners and educators in this domain.

The ongoing development of SimX’s VR capabilities is not only of value to the Department of Defense but also to the broader civilian simulation training community. The broad depth of capabilities and content equips medics with the skills needed for today’s intricate medical and combat challenges, as well as prepares them for the high-casualty scenarios of future conflicts. As military operations evolve, the continued development and expansion of SimX’s VR capabilities are vital in ensuring that the U.S. and allied forces remain at the cutting edge of preparedness.

Learn More About SimX’s VALOR!


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