Task Specific Simulations for Medical Training: Fidelity Requirements Compared with Levels of Care

There are many virtual and constructive training systems that simulate injuries as well as degrading and improving patient conditions. Most of these systems use simplistic models to mimic the physiological response to the injuries and the response to treatment. For example, when modeling bleeding from a gunshot wound, many of the models are simply based on the amount of blood loss over time. An arbitrary time limit is often established to indicate a failure to save the patient. Little to no consideration is given to the munitions type or to the baseline physiology of the individual who is shot. Also, most of these games and simulations independently reinvent the math models and the physical models of these wounds. Proprietary nature of these diverse simulation platforms results in very little reuse. This effort will explore how physiology is being represented in several simulation platforms. Targeted virtual and constructive systems include Pulse, STTCs Tactical Combat Casualty Care TC3 game, STTCsForterras OLIVE environment, and PEOSTRIs One Semi-Automated Force OneSAF. Targeted mannequins include METIs Human Patient Simulators, Laerdals SimMan and Gaumards simulators. An analysis will be done on the level of fidelity currently included in each of these systems and on the pros and cons of how the physiological and the pharmacological responses are simulated. The analysis will also include a discussion on simulating versus replicating human physiology. An initial hypothesis is that the higher fidelity medical simulations have interdependencies in the mathematical models representing different physiological sub-systems, such as bleeding, heart rate, blood pressure, etc. An attempt will be made to define a strategy for selecting the correct fidelity of human physiology models as well as ways to reuse existing models.