Virtual Simulation-Enhanced Triage Training for Iraqi Medical Personnel Paul N. Kizakevich a , Andrew Culwell a , Robert Furberg a , Don Gemeinhardt a , Susan Grantlin a , Rob Hubal a , Allison Stafford a , COL R. Todd Dombroski b a RTI International, Research Triangle Park, NC b U.S. Army Medical Corps Abstract. Triage, establishing the priority of care among casualties in disaster management, is generally practiced using constructive tabletop or live exercises. Actual disasters involving multiple casualties occur rarely, offering little opportunity for gaining experience and competency assessment. Further, when they do occur, response needs to be rapid and well-learned. In the Iraqi medical education environment where the need for triage training is immediate, but the ability to stage practice exercises is nearly impossible, the blending of didactic learning with simulation-based triage offers an alternative training methodology. Keywords: Triage, simulation, virtual patients, disaster medicine 1. Introduction As part of a U.S. Agency for International Development (USAID) project to enhance medical training in Iraq, we were asked to design and deliver a ìTrain-the Trainerî curriculum in trauma triage. Mass casualty triage is the process of establishing the priority of care among multiple casualties to rationally allocate the use of limited resources. Like most time-sensitive, high-stakes cognitive skills that are rarely used, triage requires regular practice to maintain proficiency and confidence in decision-making. Actual disasters, such as explosions, hurricanes, or toxic exposures, occur so rarely that there is little opportunity for gaining experience. Constructive tabletop simulations are abstract mental exercises without direct patient interaction. The expense of obtaining, training, and moulaging multiple actors for live training exercises usually forces triage training to be incorporated into collective training exercises designed for the entire disaster response infrastructure. To provide an alternative methodology, including individual self-paced learning, we developed a blended didactic and simulation-based curriculum in multiple- casualty triage.