Exploring Triage Performance in Mass Casualty Incidents: Comparing Virtual vs Real Patient Actors in Augmented Reality

Augmented reality has shown promise as an assistive tool for mass casualty incident (MCI) triage to facilitate cognitive support during live response and to furnish immersive virtual MCI training. It has been shown that women and people of color experience less effective triaging in emergency room settings, yielding diminished healthcare outcomes. In the more chaotic and austere MCI event, triage efforts further determine which patients are left to expire and which get life-saving interventions before they arrive at the hospital. This work offers an exploratory within subjects investigation with actual first responders (N = 13) to examine preliminary patterns about whether diminished triage efficacy based on patient demographics can be captured during an augmented-reality virtual training simulation (1V) and/or within a 'real' patient training simulation (supported with AR triage interfaces) with patient actors (2R). While both conditions used a Hololens2, the 1V condition displayed AR virtual patients, whereas the 'patient actor' condition had real people scattered in a physical space needing triaged. We conduct ANOVAS and construct linear models to evaluate our data. Our exploratory analysis finds slight potential impacts of patient demographics in triage efficacy within the 'real' simulation, and more severe impacts in the virtual simulation. We further discuss implications of this work and explore underlying cognitive factors.