# The Use of Virtual Reality in Training Parameters for a Mass Casualty Incident
## 2 Related Work  
Unlike mixed reality and augmented reality, virtual reality has a wide range of applications, whether it be video games, virtual parks, modern gadgets, and education [4; 5; 6; 7; 8]. As needs have changed over time, virtual reality, especially from the gaming sphere, has moved into commercial applications where its nature and use of experiential learning has come into play [9]. Virtual reality in the context of employee training brings several benefits not only in industrial fields, but also in fields focused on the care of human life and health. The main advantages include the complete autonomy of training within the framework of staff update training, which in practice means that the employee can train, practise, and generally develop at any time and virtually anywhere, there is no need for the presence of another person, everything is taught by a specialized virtual reality application. In addition, in the field of paramedicine, the demanding logistical operations in terms of legislative, administrative, material, financial and personnel preparation for real-time exercises are eliminated. The rare encounter with critical situations, which undoubtedly include mass casualty situations, makes the practical training of a paramedic challenging within the limited time frame of a curriculum or development plan. In addition to structured procedures based on medical algorithms, the experience helps paramedics develop competencies in task coordination and teamwork in dynamically changing situations. Such comprehensive competence can hardly be acquired through existing conventional training methods. Virtual reality environments are proving to be a suitable alternative [10; 11; 12; 13]. Each training course should be designed to promote a positive learning experience in a supportive environment to enable students to reproduce the experience in their professional practice. For these reasons, it is recommended to incorporate constructivist teaching methods into the educational process, especially active learning, which is a method that allows students to actively try and work with the knowledge and skills they already have or need to acquire. This is based on the premise that learning is an active rather than a passive process, whereby students learn best in an appropriate environment the skills and knowledge that they try out and practise themselves. The whole process of active learning is related to the system of cognitive assimilation and accommodation, and the importance of a suitable educational environment is crucial. An integral part of active learning is also a part of reflection on performance, whether it is one's own or provided by another person [14]. Several previous studies have already shown that paramedics can be trained remotely, and the effectiveness of virtual reality as a platform for training paramedics has been demonstrated [15]. Research suggests that simulating infrequently performed procedures or training for infrequent to rare situations leads to increased professional confidence when performing a procedure on a real patient or accident scene [16]. In the event of a mass casualty incident, a paramedic is required to perform several tasks that are regularly trained in disaster management exercises. These tasks include determining the organizational structure, diagnosing all involved patients, administering medications to patients depending on their health status and injuries, and transporting them to the hospital facility. In such situations, there are usually a limited number of paramedics available to treat all injured patients. For this reason, too, the so-called triage, i.e., the classification of patients according to the severity of their injuries, is applied at the beginning of the intervention. The START triage system divides injured persons into four groups using coloured tags to mark them. This method helps to easily identify patients in need for urgent help as well as patients for whom treatment would be futile. Its advantage is particularly its speed.