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A ‘mixed reality’ simulator concept for future Medical Emergency Response Team training
  1. Robert J Stone1,
  2. R Guest1,
  3. P Mahoney2,
  4. D Lamb3 and
  5. C Gibson4
  1. 1University of Birmingham, EESE, Birmingham, UK
  2. 2Academic Department of Military Anaesthesia and Critical Care, Royal Centre for Defence Medicine, Birmingham, UK
  3. 3Academic Department of Military Nursing, Royal Centre for Defence Medicine, Birmingham, UK
  4. 4Clinical Policy, Royal Army Medical Corps, Royal Centre for Defence Medicine, Birmingham, UK
  1. Correspondence to Professor Robert J Stone, Human Interface Technologies Team, University of Birmingham, EESE, Pritchatts Road, Birmingham B15 2TT, UK; r.j.stone{at}


The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in ‘mission-specific’ contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on ‘mixed reality’ technologies—in effect the ‘blending’ of real-world objects of training relevance with virtual reality reconstructions of operational contexts.

  • MERT
  • Virtual Reality
  • Human Factors
  • Mixed Reality
  • Technology-Based Training
  • Fidelity

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  • Contributors The material presented in the Introduction section was provided mainly by the military coauthors (PM, RG, DL). PM and RG also conducted a final proofread of the paper. The remainder of the paper was written by RJS and RG.

  • Funding This study was undertaken as part of a subcontract placed upon the University of Birmingham by the Medical Directorate of Joint Medical Command (Royal Centre for Defence Medicine) via the University of Birmingham Hospitals NHS Foundation Trust (Ref. 20140212_DMSRSG).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.