Bridging Simulation and Reality: Augmented Virtuality for Mass Casualty Triage Training - From Landscape Analysis to Empirical Insights

Live drills are the gold standard for mass casualty incident (MCI) training but are often too resource-intensive for widespread implementation. Immersive technologies offer a promising alternative, but can they deliver comparable fidelity and effectiveness? Working with a local disaster response academy, this paper investigated the potential of Augmented Virtuality (AV) in MCI training through two phases. First, we conducted a landscape analysis of 126 papers across the virtuality continuum, revealing trends in population, training focus, and evaluation metrics. Second, we empirically evaluated an AV system for mass casualty triage training against traditional role-playing and Virtual Reality (VR) approaches, involving 60 trainees in an operational curriculum. Results indicated that both AV and VR surpassed traditional simulations, with AV’s tactile integration significantly enhancing physical engagement, satisfaction, and triage accuracy. Through the lens of triage, we discussed the broader practical implications of integrating immersive technologies like AV into real-world MCI education.