Clackamas, OR, Crews Hone Skills at Scenarios Created by Virtual Reality Software

A man lies motionless in the middle of the road, a mangled bike at his feet, his white shirt stained with blood. Leaning over him is another man, who’s trying to administer CPR.

In the distance sits a crushed car that has veered off the road and into a building. A few other people are nearby, looking stunned.

When you arrive, the injured man is unresponsive, blood pooling around his body.

This moment offers you a chance to do the most important thing you can ever do – save a person’s life. It’s also completely fake.

All of the people you see are simulated characters in a new virtual-reality program that the Clackamas Fire District soon will begin using to train its firefighters and paramedics. The software immerses first responders in various high-stress scenarios, including terrorist attacks, shootings and protests.

The user knows, of course, it’s all fake, but it doesn’t feel fake. It often feels eerily real.

At first, the noise and moving characters are so immersive it’s disorienting. But after a few seconds, after you turn the injured man onto his side to conduct a spinal assessment and he wheezes in pain, you push through the uncanny-valley aspect of the environment and half-forget you’re not actually at a crash scene.

The headsets the trainee wears can be purchased on Amazon for $199, but the software — created by the Australian company EmergiSim — comes with a $50,000 price tag. That cost for Clackamas Fire is being covered by a federal grant from the U.S. Department of Homeland Security, Chief Rick Huffman said.

Huffman’s department is only the second in the nation to implement EmergiSim’s virtual-reality programming, which allows first responders to prepare for situations that are difficult to recreate through real-life training. The first to use it, Emergency Medical Services Authority in Oklahoma, started working with the VR programming in 2021, with mixed results.

“The bottom line with this type of training is: How do we train for a lot of victims,” Huffman said. “That’s something we don’t do very often.”

A big attraction of VR, for Huffman, is simply that it appears to work. A 2021 study by researchers at Nanjing Medical University in China found that, out of 633 students in the study, those who had trained with VR performed significantly better on exams and other tasks than students who had learned using traditional, real-world methods.

For first responders, the VR training appears to help them retain the large amount of information about emergency procedures associated with their field, Huffman said.

It does this by testing the trainee at each stage of a response. As the firefighter or paramedic is treating a man with an arm wound, for example, a hovering box offers options, like checking vitals or conducting an electrocardiogram test. At the end of the session, the software scores the various actions the user took based on established emergency protocols.

As it turns out, the hovering action box doesn’t detract much from the realism of the virtual-reality scene. It’s intuitively placed in the corner of your vision; to look at it, you have to turn your body away from the person you’re treating.

This kind of immersive practice is much more engaging than taking notes in a classroom, Huffman said.

Dr. John Turner, Clackamas Fire’s director of emergency medical services, noted the psychological benefits of a simulated emergency scene.

Being able to restart a simulation and act differently the next time through “creates the opportunity for lower-stress training in what can be very stressful situations,” he said.

Before Huffman can hand out the VR headsets, he and Clackamas Fire’s IT team still have some kinks to work out. On the day the Oregonian/OregonLive tested the equipment, one of the simulations got stuck on the EmergiSim loading page – apparently not an unusual problem.

At Oklahoma’s Emergency Medical Services Authority, the VR program remains, even after three years, in the testing phase.

The agency’s spokesperson, Adam Paluka, attributed the pause to “significant organizational changes” in the department.

“We’re still tweaking how we’re using virtual reality and training,” Paluka said.

There’s also the issue of nausea and vertigo that VR can induce, with one study finding that 5% of virtual-reality users are not able to withstand prolonged exposure. To combat that problem, Huffman said all the training also will be available in standard video format.

But videos, Huffman said, don’t have the same pedagogical effect on the brain that VR does.

“The cognitive science behind virtual reality is proven,” he said. “Your brain thinks you’re actually there.”

Huffman, 63, has been exploring VR’s potential for first responders for years.

He discovered the technology in 2016 when he managed Concordia University’s simulation facility. Later, during the Covid-19 pandemic, he implemented a rudimentary form of the VR training for Gladstone firefighters.

After Clackamas Fire took on providing firefighting services to Gladstone in 2021 and Huffman became chief the following year, he applied for a federal grant to continue funding the virtual-reality training.

The advances in the technology in just a few short years have been significant, said Turner, Clackamas Fire’s head of emergency medical services.

“Having crowd noise in the headset, having sirens going in the headset, just makes it very real,” he said. “It takes it to the next level.”

If all goes well with software fixes and getting instructors up to speed, Huffman plans to roll out the training by late summer and, eventually, have virtual reality in each of the fire department’s 25 stations.

Huffman said VR helps answer a perennial question of the trade: how do you train for everything a firefighter could face – which is just about anything?

“Nothing replaces real,” he said, “but this inoculates you [against the stress of the real thing]; this prepares you.”

– Sujena Soumyanath is a reporter on The Oregonian/OregonLive’s public-safety team. You can reach her at 503-221-4309 or [email protected]

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