Evidence map›Paper›PMID 39869892›Full record

ArticleJournal of medical Internet research2025

Mass Casualty Incident Training in Immersive Virtual Reality: Quasi-Experimental Evaluation of Multimethod Performance Indicators.

Anke Sabine Baetzner, Yannick Hill, Benjamin Roszipal, Solène Gerwann, Matthias Beutel, Tanja Birrenbach, Markus Karlseder, Stefan Mohr, Gabriel Alexander Salg, Helmut Schrom-Feiertag and 2 more

Abstract read
In one paragraph

Article in Journal of medical Internet research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Anke Sabine BaetznerInstitute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany.ORCID 0000-0001-5366-8184
Yannick HillDepartment of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.ORCID 0000-0002-4382-2149
Benjamin RoszipalMindConsole GmbH, Graz, Austria.ORCID 0000-0003-4276-9507
Solène GerwannInstitute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany.ORCID 0009-0004-5473-5982
Matthias BeutelInstitute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany.ORCID 0009-0000-7013-6868
Tanja BirrenbachDepartment of Emergency Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-3046-0900
Markus KarlsederMindConsole GmbH, Graz, Austria.ORCID 0000-0003-2773-0727
Stefan MohrMedical Faculty, Heidelberg University, Heidelberg, Germany.ORCID 0000-0003-4292-663X
Gabriel Alexander SalgMedical Faculty, Heidelberg University, Heidelberg, Germany.ORCID 0000-0002-3964-3527
Helmut Schrom-FeiertagAIT Austrian Institute of Technology, Vienna, Austria.ORCID 0000-0002-5327-2494
Marie Ottilie FrenkelInstitute of Sports and Sports Sciences, Heidelberg University, Heidelberg, Germany.ORCID 0000-0003-0646-2612
Cornelia WrzusPsychological Institute and Network Aging Research, Heidelberg University, Heidelberg, Germany.ORCID 0000-0002-6290-959X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundImmersive virtual reality (iVR) has emerged as a training method to prepare medical first responders (MFRs) for mass casualty incidents (MCIs) and disasters in a resource-efficient, flexible, and safe manner. However, systematic evaluations and validations of potential performance indicators for virtual MCI training are still lacking.

objectiveThis study aimed to investigate whether different performance indicators based on visual attention, triage performance, and information transmission can be effectively extended to MCI training in iVR by testing if they can discriminate between different levels of expertise. Furthermore, the study examined the extent to which such objective indicators correlate with subjective performance assessments.

methodsA total of 76 participants (mean age 25.54, SD 6.01 y; 45/76, 59% male) with different medical expertise (MFRs: paramedics and emergency physicians; non-MFRs: medical students, in-hospital nurses, and other physicians) participated in 5 virtual MCI scenarios of varying complexity in a randomized order. Tasks involved assessing the situation, triaging virtual patients, and transmitting relevant information to a control center. Performance indicators included eye-tracking-based visual attention, triage accuracy, triage speed, information transmission efficiency, and self-assessment of performance. Expertise was determined based on the occupational group (39/76, 51% MFRs vs 37/76, 49% non-MFRs) and a knowledge test with patient vignettes.

resultsTriage accuracy (d=0.48), triage speed (d=0.42), and information transmission efficiency (d=1.13) differentiated significantly between MFRs and non-MFRs. In addition, higher triage accuracy was significantly associated with higher triage knowledge test scores (Spearman ρ=0.40). Visual attention was not significantly associated with expertise. Furthermore, subjective performance was not correlated with any other performance indicator.

conclusionsiVR-based MCI scenarios proved to be a valuable tool for assessing the performance of MFRs. The results suggest that iVR could be integrated into current MCI training curricula to provide frequent, objective, and potentially (partly) automated performance assessments in a controlled environment. In particular, performance indicators, such as triage accuracy, triage speed, and information transmission efficiency, capture multiple aspects of performance and are recommended for integration. While the examined visual attention indicators did not function as valid performance indicators in this study, future research could further explore visual attention in MCI training and examine other indicators, such as holistic gaze patterns. Overall, the results underscore the importance of integrating objective indicators to enhance trainers' feedback and provide trainees with guidance on evaluating and reflecting on their own performance.

Indexed as

Emergency RespondersMass Casualty IncidentsVirtual RealityAdultFemaleHumansMaleTriagedisaster medicineemergency medicineemergency simulationeye trackingmass casualty incidentmedical educationprehospital decision-makingvirtual reality

Identifiers

PMID39869892
PMCPMC11811659

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.