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Casualty Care Training- Mixed Reality Manikin Solution for Female Soldier Survivability


OUSD (R&E) CRITICAL TECHNOLOGY AREA(S): Combat Casualty Care; Human-Machine Interfaces OBJECTIVE: Develop, demonstrate, and deliver solutions for enhanced female combat trauma mixed reality (MR) training manikin that incorporates open architecture utilizing high fidelity simulations for combat-trauma-related scenarios. DESCRIPTION: A study of the Army’s medical training literature found significant disregard for the anatomical and physiological differences between males and females resulting in lower survivability rates for female casualties in comparison to males: 35.9% vs 17% and 14.5% vs 12% (Operation Iraqi Freedom) (Cross, Johnson, Wenke, Bosse, & Ficke, 2011). The Army currently trains Soldiers using male manikins when teaching Tactical Combat Casualty Care (TCCC). The Army is looking to invest in technology that improves training to better care for Soldiers, specifically female Soldiers, on the battlefield and save lives at point of injury. Training using realistic, female anatomy can help reduce hesitation to provide treatment of battlefield injuries and reduce female deaths. The Army is seeking a solution for a hybrid training tool utilizing a combination of augmented reality, virtual reality, and physical manikins to address female combat casualty care. To build out the best-in-breed training solution, all components need to be open architecture with plug-and-play capabilities to develop modular training independent of gender or scenario. While medical training is extremely hands-on, and the ability to physically feel what is happening is critical in training, virtual training provides ease and modularity for creating different training scenarios and reduces the cost of training. Currently, trauma medical training is done in either virtual or physical training environments. There are limitations for both approaches but combining the two will increase training effectiveness and reduce costs overall. Current Army medical training is male-centric with significant gaps in female trauma care (Bell, Thomson, Mazzeo, & Pike, 2020). According to the Department of Defense Personnel and Readiness Report of 2019, 14.9% of the United States Army population is female (2019, p. 93). This effort will not only move the needle to address female needs on the battlefield for the military, but it will also have applications in the civilian sector, better preparing medical professionals for trauma cases. PHASE I: Design a proof-of-concept solution for an end-to-end system, or components of a system that effectively trains Soldiers utilizing an anatomically correct physical female manikin, physical task trainers, software simulators/trainers, and provides Soldier training feedback. Solutions will be evaluated based on a holistic view of factors including the ability to integrate designated Army open standards, cost of development, adaptability of solution based on individual Soldiers’ needs or scenarios, and any additional factors proposed. The objective of Phase I is to establish the technical merit, feasibility, and commercial potential of the proposed effort, and to determine the quality of performance of the awarded companies prior to providing further support in Phase II. Final deliverable will be a concept design presentation, proof of technology demonstration, and plans for follow-on Phase II work. Companies can voluntarily participate in the Army Applications Laboratory (AAL) 12-week cohort program. The AAL cohort program is designed to solve specific Army modernization challenges on a compressed timeline. The cohort program matches qualified companies with Army problem owners to speed capability development, accelerate transition, and de-risk or inform requirements. This program is designed for businesses that own unique, applicable technology and are interested in growing a new line of business through the DoD. The cohort program will enhance technology development through rapid exposure to Army stakeholders and the Army medical simulation community. Planned activities include a problem topic deep dive, a field week with Army leaders and Soldiers, hands-on experience with currently fielded military equipment, and stakeholder engagement from the requirements writer, to the acquisition manager, to the end-user. An example cohort program for this topic is: Week 1 – Orientation and problem deep-dive (virtual) Week 2 – Soldier Touchpoint (in-person at an Army installation) Week 3-6 – Concept research and planning Week 7 – Mid-point concept design brief to Army Senior Leaders and SME roundtable discussion (in-person at an Army installation) Week 8-11 – Concept design refinement Week 12 – Final concept design brief to Army Senior Leaders (in-person at an Army installation) Cohort programming will be provided free of charge. Proposers who plan to participate in the cohort (if awarded a Phase I) are encouraged to include travel costs for three cohort trips, within the continental US, for four to five days each for in-person programming. In-person events may be substituted for virtual events depending on COVID-19 travel restrictions. Details will be provided to awardees under this topic at Phase I award. PHASE II: Design a prototype demonstration for the continued development efforts initiated in Phase I. Prototypes should be capable of integration with existing Army systems or newly developed systems from other awardees. They should also showcase modularity and prove effective during simulated or operational demonstrations. Phase II deliverables include a demonstration and delivery of a Technology Readiness Level (TRL) 6 prototype for further Army evaluation, as well as quarterly and final reports detailing design and performance analysis of the prototype. Awardees may also be eligible for Phase IIb award after completion of Phase II period of performance. Phase IIb can extend the period of performance with additional funding and additional matching opportunities to finish building out solutions with the stakeholders’ discretion. PHASE III: The objective of Phase III, where appropriate, is for the small business to pursue commercialization objectives through the effort. Companies may develop a manufacturing-ready product design, capable of integration with the existing or future system, and demonstrate technology integration. Low-rate production will occur as required. Companies will engage in laboratory or operational testing as required. Phase III deliverables include system-level integration technical data package, installation documentation, and system-level prototype for demonstration and government-sponsored testing WEBINAR DATE: Two Webinars will be conducted with this solicitation on Tuesday, 21 March: Webinar 1 (1500-1600 CST) and Thursday, 23 March: Webinar 2 (1200-1300 CST). Please register at: KEYWORDS: Female Manikin, Combat Casualty Trauma, Combat Trauma Manikin, MOHSES, Augmented Reality Medical Training, Virtual Reality Medical Training, Open Architecture REFERENCES: Bell, E. Thomson, R., Mazzeo, M. Pike, W. (2020). Same injury, different outcome? Investigating hesitation while treating female casualties. Proceedings of the 2020 Interservice/Industry Training, Simulation, and Education Conference. Cross, J. D., Johnson, A. E., Wenke, J. C., Bosse, M. J., & Ficke, J. R. (2011). Mortality in female war veterans of Operations Enduring Freedom and Iraqi Freedom. Clinical Orthopaedics and Related Research®, 469(7), 1956-1961.Retrieved November 21 from MoHSES, the Advanced Modular Manikin Phase 2 Standards(2015). Retrieved November 3 from Office of the Under Secretary for Personnel and Readiness Report, 2019. Retrieved October 2, 2019 from Reed, A. M., Janak, J. C., Orman, J. A., & Hudak, S. J. (2018). Genitourinary injuries among female US service members during Operation Iraqi Freedom and Operation Enduring Freedom: findings from the Trauma Outcomes and Urogenital Health (TOUGH) project. Military Medicine, 183(7-8), e304-e309. Sotomayor, T. M., Mazzeo M. V., Maraj, C. S., & Page, A. J. (2018). Saving female lives using simulation: elevating the training experience.. Launching Innovation Through Medical Modeling and Simulation Technologies, 6(4), 28 – 37. Retrieved October 2, 2019, from
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