Fatigue impact of mixed reality in mass casualty incidents training

Background
Fatigue is a multifaceted state characterized by a significant lack of energy or motivation; which is perceived by the individual to interfere with usual and desired activities; it can hinder an individual’s functioning. In recent years, the rise of Mixed Rality (MR) technologies has introduced new dynamics in emergency training. MR environments blend real and virtual elements, facilitating immersive experiences in education, product design, and beyond. However, these environments also present unique challenges regarding user fatigue. Prolonged interaction with MR systems can lead to both physical fatigue, due to sustained movement or attention, and mental fatigue, driven by increased cognitive demands and complexity of tasks. This interaction can adversely affect user performance, learning, and overall experience. Mental fatigue negatively affects concentration, memory, and decision-making. Research on the psychological effects of fatigue from the use of MR in emergency professional training is crucial, but the understanding of its effects is still evolving.
Objectives
The study aims to assess fatigue experienced by participants during MR training focused on multi-victim incident resolution, and to identify key factors that influence user experience and learning outcomes.
Methods
This study used a quantitative approach with a cross-sectional study design. The sample technique used total sampling. Respondents were trainees from an MR training about MCI. The research instrument used the MR Fatigue Scale questionnaire. A validated fatigue scale was used to assess five domains of fatigue (general, social, emotional, visual and motivational fatigue) after MR training. The scale was specifically designed for use in mixed-reality professional training.
Results
The study involved 260 participants. The participants were emergency and non-emergency physicians, emergency nurses and paramedics (173 men, 87 women; mean age = 40.16 years, mean work experience = 12.28 years). It was a multi-country study from six European countries: Austria, Belgium, Germany, Greece, Spain and Sweden. Apart from their previous background, the participants were trained in MR as part of the MED1stMR project. The MR fatigue scale identified significant dimensions of fatigue, with general and visual fatigue having the greatest impact. Medical professionals reported higher levels of visual fatigue compared to other professions involved in the training.
Discussion
In assessing the result that doctors had a higher level of fatigue, it may be interesting to correlate responsibility and degree of fatigue as a contributing factor in this type of training.
Conclusion
The study highlights the key dimensions of fatigue in emergency professional MR training and values the importance of addressing visual and general fatigue to improve user experience and learning outcomes in future MR training programs for emergency and medical first responders (MFRs).