# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 2 Related Work
The use of virtual reality in teaching seems to be influenced by teacher training and program resources, but the lack of data and re-flection of traditionally designed exercises using mannequins has had its influence here for a long time [28]. Traditional training of paramedic students and professional paramedics is carried out using simple intubatable mannequins or volunteer students or colleagues with a training version of the equipment that is standardly used in pre-hospital care by a medical team consisting of a doctor and a paramedic. Training is conducted on a regular basis, both in the case of professional paramedics at the base, in the case of students in a college setting, and in both cases out in the field. Scenarios are led by scenario facilitators. Facilitators are typically senior physicians/paramedics who instruct the training team and manage the scenario, patient assessment results, and simulated responses to interventions and treatment. To enhance realism, other actors are often used in the scenarios to take on the roles of bystanders, other personnel, or other integrated rescue system components (in case the relevant integrated rescue system component, i.e., police or firefighters, are not the ones requested to participate). The scenario participants are briefed and realistically introduced into the scene [28; 29]. The described approach is the traditional approach to training and exercising paramedics. However, not enough attention has yet been paid to the emotional perspective of the paramedics themselves and the level of preparedness of the figurants with respect to the stress response and the level of authenticity. It is undeniable that the approach described provides a safe environment for learning, practising, and maintaining skills in pre-hospital emergency care. This teaching and maintenance of skills are essential to an effective prehospital trauma care system. On the other hand, they require relatively extensive logistical support and, in the case of the involvement of other components of the integrated rescue system, considerable costs, as verified in this study by the GURD exercise described below, which was exceptional precisely because of the massive involvement of all components of the integrated rescue system. Depending on the complexity of the scenario, simple scenario-based training using mannequins is feasible on a relatively large scale and, in the case of the involvement of a limited number of paramedics without the participation of other components of the integrated rescue system, has the advantage of low cost and rapid preparation. The range of scenarios here is limited by the imagination of the trainers. However, it is essential to keep in mind that sufficient effort must be made to get the trainees into the zone, i.e., into a psychological setting in which they believe they are in a real environment and treating a real patient. Only then can they get the most out of the learning module. Although this method can be used for many aspects of a paramedic's work, whether it is learning new skills, communication, and leadership, and maintaining existing skills, it is the realism of the training concept and entering the zone that tends to be problematic in many cases. The method described here is a low-tech and low-cost alternative to technologically demanding simulations that, when properly prepared and executed, can be a useful adjunct to delivering effective training. It can be considered useful for both initial and regular training of prehospital trauma care providers [29]. However, the authors of this study believe that, based on the action research conducted, it is appropriate to begin continuously supplementing the type of exercises with virtual reality modules for their benefits described above and to bridge the basic disadvantages of these mostly low-cost alternatives to technology-intensive simulations.