Instructional Games, Game-Based Simulation, Training Effectiveness Evaluation


The use of military forces in urban operations has increased considerably over the past years. As illustrated by the current conflict in Iraq, the Army finds itself fighting its toughest battles in urban areas facing unconventional forces. Soldiers face many threats in hostile fire environments, whether conducting large-scale mechanized warfare, low-intensity conflicts, or operations other than war. Through 1970, there has been no demonstrable reduction in battlefield mortality rate as a percentage of all casualties since data was kept since before the Civil War. For that period of time, nearly all the reduction in overall mortality rate occurred through reduced mortality in Hospital Chain. As of 1970, about 90 percent of all combat deaths occur before a casualty reaches a definitive care facility. Tactical Combat Casualty Care (TCCC), also known as TC3, is the pre-hospital care rendered to a casualty in a combat environment. The application of TCCC principles during a tactical combat environment has proven highly effective and is a major reason why combat deaths in latest conflicts (Operation Iraqi Freedom and Operation Enduring Freedom) are lower than in any other conflict in the history of the United States. The Army continues to emphasize reducing battlefield mortality rate. Current tools and methods used for initial skills and sustainment training of combat medics throughout the Army are insufficient. New technologies are needed to provide medics with greater opportunities to develop and test their decision making and technical medical skills in multiple, COE-relevant, training scenarios. In order to address some of these requirements, the U.S. Army Research Development and Engineering Command, Simulation and Training Technology Center (RDECOM-STTC) is developing the 68W - Tactical Combat Casualty Care Simulation (TC3 Sim) for the US Army Medical Department (AMEDD) Center & School at Fort Sam Houston. The Army is considering the use of the TC3 Sim game as a tool to improve the training of individual Soldiers as well as improve the readiness of combat medics. It is the intent of this research to evaluate the effectiveness of instructional games in general and the use of the TC3 game in particular for teaching the concepts of tactical combat casualty care. Experiments were conducted to evaluate the training effectiveness of this tool in supporting the 68W10 Healthcare Specialist Course program of instruction (POI). The goal of this research is to address important questions such as: Is this game an effective tool to train Soldiers the aspects of TC3? Can knowledge gain through the use of the simulation be transferred into task related situations? How can this tool be incorporated in the current POI in order to increase training effectiveness?


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Graduation Date



Proctor, Michael


Doctor of Philosophy (Ph.D.)


College of Engineering and Computer Science

Degree Program

Modeling and Simulation








Release Date

September 2009

Length of Campus-only Access


Access Status

Doctoral Dissertation (Open Access)

Included in

Engineering Commons