Medical, modeling, simulation, virtual reality, cricothyroidotomy, surgical, education, training, medics, learning, procedural, usability, fidelity, anatomy, physiology


Simulation for surgical education and training is increasingly perceived as a valuable contribution to traditional teaching methods providing a structured learning experience. Surgical simulations allow surgeons to practice tactics, techniques and procedures numerous times without the cost, limitations and ethical problems of using cadaver-based models. The goal of this research is to advance the use of modeling and simulation in support of emergency medical training. This research explores questions identified through a case study of two different modeling and simulation techniques – virtual reality and mannequins - in the support of combat emergency medical education and training. To reduce the scope to a manageable dissertation, the research focuses on CricSim as representative form of virtual reality simulation and HapMed as a form of mannequin simulation both with hapticenabled capabilities. To further narrow the scope, the research focuses on training of a medical technique common to both simulation systems, which for this research was the cricothyroidotomy airway management technique. The U.S. Army expressed interest in training of combat medics in the cricothyroidotomy airway management technique and offered to support experimentation with both facilities and trained combat medics as the sample population. An experiment supporting this research took place at Fort Indiantown Gap, a National Guard Training Center located in Annville, Lebanon County, Pennsylvania and is the iv home of the Medical Battalion Training Site. An advanced airway management course is augmented with combat medics receiving training and evaluation on performing the cricothyroidotomy procedure using CricSim and HapMed with system experts provided by each respective developer. The NASA Task Load survey is used to collect participants’ assessment of workload in terms of Mental Demand, Physical Demand, Temporal Demand, Level of Effort, Performance and Level of Frustration based on four primary tasks of the cricothyroidotomy. Additionally, the Technology Acceptance Model survey is used to provide insight into participant’s assessment of usability. Professional trainers also provide their assessment of the virtual simulators suitability in support of the combat medics in performing their tasks based on their standards. The results of the participants’ assessment of each virtual simulator take the form of a comparison study. To improve the advancement of medical simulation in the training of cricothyroidotomy procedure, a summary of findings, generalized conclusions, lessons learned and recommendations for future research are illuminated. The dissertation team is comprised of medical experts within the U.S. Air Force Education and Training Command, U.S. Army Research and Medical Command, and the Uniformed Services University of the Health Sciences as well as simulation subject matter experts from the University of Central Florida.


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Graduation Date





Proctor, Michael


Doctor of Philosophy (Ph.D.)


College of Engineering and Computer Science


Industrial Engineering and Management Systems

Degree Program

Modeling and Simulation; Engineering








Release Date

February 2015

Length of Campus-only Access

1 year

Access Status

Doctoral Dissertation (Open Access)


Dissertations, Academic -- Engineering and Computer Science, Engineering and Computer Science -- Dissertations, Academic

Included in

Engineering Commons