Examination of Surgical Skill Performance under Combat Conditions Using a Mannequin-Based Simulator in a Virtual Environment

摘要

The present study examined the performance of a surgical procedure under simulated combat conditions. Fifteen medical students were taught to perform a tube thoracostomy on a mannequin-based simulator in a traditional medical school setting under the direction of an ATLS-certified surgeon. The participants then performed the procedure in a fully immersive CAVE virtual environment running a combat simulation including gunfire, explosions, and a virtual sniper under both daylight and nighttime conditions. The results showed that completion times depended on the order of daylight and nighttime conditions with a slight disadvantage for the nighttime condition. However, the quality of the procedures performed by the students suffered in the simulation and particularly under the nighttime conditions. Further, there were nine instances in which the participants were killed by the virtual sniper before completing the procedure. Taken together, these results suggest that the surgical skills acquired by students in a traditional medical school setting may be compromised when they are called upon to perform them under hazardous conditions. Further, the findings from this study show that virtual environments can provide a safe environment for military medical personnel to train for dangerous duty.