# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 7 Conclusions  
The training of paramedics is an integral part of not only their professional training within the study of the relevant field, but also a tool for updating information and practising skills in common situations, but also those that are rare. It is because of this that they are challenging for a rescuer, as he/she is not frequently exposed to them in real practice, encounters some of them only rarely, and therefore in a situation where he/she will intervene in the case of, for example, mass disability of persons, with which he/she has neither direct nor sufficient training experience in the past, it can be assumed that his/her performance will be affected. The authors of this article do not believe that regular paramedic exercises can be fully replaced by virtual reality modules; however, they believe that virtual reality environments are so flexible, adaptable to the paramedic's reactions in a given situation, that they can become an important complement to standard exercises and at the same time a tool for more intensive training, as the paramedic can work with the module regardless of time and space constraints. The authors' team carried out action research, in the initial phase of which the described training of all integrated emergency services was prepared. The training given was seen as an opportunity to reflect on the logistical demands of training, but also as an environment that has the potential to reveal the shortcomings of the experienced approach of training paramedics using models and mannequins. Based on observation, evaluation of the conference discussion, a questionnaire survey of mannequins and interviews with participants, problematic variables in this training approach were evaluated and collaboration with external consultants from the medical and paramedic communities was established. Based on the analysis of mass casualty incidents, it was decided that a module for training paramedics in a virtual reality environment would be developed and subsequently programmed. The development of the module was based on the expert group, which was composed of experts from several disciplines. Now, the module is fully ready for further testing and implementation. In relation to future development, the authors' team plans to use real smartwatches for biometric data capture and semi-structured interviews with two groups of probands, one undergoing a traditional training model and the other undergoing training in a virtual reality environment, with the scenario and requirements being correlated for both groups. In addition, the preparation of two more modules is being considered. These modules would serve as a virtual tool for paramedics (and with minor specific modifications also potentially the whole integrated rescue system) to train professionals in a safe environment, considering the cost-effectiveness of this method and approach in comparison with the organisation of extensive training in a real environment. Conceptualization, M.B., M.S., P.H. and A.L. ; methodology, M.B., M.S., P.H. and A.L. ; software, M.B., P.H. and M.S. ; validation, A.L., S.R. and K.G. ; formal analysis, A.L. ; investigation, A.L., M.S. and M.B. ; resources, M.B., M.S. and P.H. ; data curation, A.L., M.B., P.H. and M.S. ; writing--original draft preparation, A.L., M.S., S.R. and K.G. ; writing--review and editing, A.L., M.B. and M.S. ; visualization, A.L., M.B., P.H. and M.S. ; supervision, M.S., P.H. and M.B; project administration, A.L., M.S., P.H. and M.B. ; funding acquisition, M.S. All authors have read and agreed to the published version of the manuscript. This work was supported by the Internal Science Foundation of the University of West Bohemia under Grant SGS-2021-028 Developmental and Training Tools for the Interaction of Man and the Cyber-Physical Production System' and with the financial support of the European Union, as part of the project entitled development of capacities and environment for boosting the international, intersectoral and interdisciplinary cooperation, project reg. No.