Medical and military training, managing and treating mental health conditions and virtual tours of museums are just a small handful of the possible uses of VR. New advances in this area mean that the potential applications are expanding all the time. In the air medical world, flight simulators and VR aircrew trainers can be used to enhance various types of crucial training. SAR missions can be fraught with danger and team members require specific skill sets and extensive training to ensure they have both the confidence and ability to succeed in often perilous situations. VR is a useful way to safely insert team members into simulations of situations they may encounter.

VR is a useful way to safely insert team members into simulations of situations they may encounter

For example, the LifeFlight Training Academy utilises VR for training helicopter pilots and aircrew officers. “It’s an efficient way of exposing crews to a vast range of situations, in a controlled environment,” said Peter Elliot, LifeFlight Training Academy General Manager. Elliot told AirMed&Rescue about the Academy’s two simulators: “The Aircrew Officer Virtual Reality simulator was introduced in 2020, to help train aircrew in winching and other operational skills needed in the aeromedical and SAR world. Physically, it’s a basic replica of a helicopter cabin, with a moving winch cable and winch pendant. The trainee wears a VR headset and the relevant safety gear – and performs missions designed by the trainer, which are played through the headset,” he said. “The Academy also features a Thales Reality H AW139 Level D Full Flight Simulator. While typically not considered VR in the same sense as the aircrew simulator, this is used to train helicopter pilots in a mission-oriented, regulated environment. It includes the same control panels and instruments as real AW139 aircraft and immerses the trainee in the scenario with large screens and audio, while actually moving in accordance with the flight.”

LifeFlight’s flight simulator software is run by Thales, while at VRM Switzerland – which builds realistic and professional flight training solutions – the team has developed its own software in cooperation with IPACS Aerofly FS. Excitingly, VRM-Switzerland has created the world’s first VR training device to be approved by the European Union Aviation Safety Agency (EASA). AirMed&Rescue spoke with VRM-Switzerland’s CEO Fabian Riesen, who told us more about what this entailed: “We had to meet requirements such as a high-resolution representation of the cockpit and the landscape. To operate close to ground with a helicopter, exactly replicated ground structures are vital. All this at a fast image build rate. In addition, the correct simulation of the helicopter’s behaviour is essential for professional pilot training,” he commented.

AirMed&Rescue also spoke with Airlec, a market leader in aeromedical transportation that is currently working on VR solutions for medical training and is in the process of designing an in-house VR component for VR-based medical training. Managing Director Paul Tiba believes there is a gap in the market here: “At this point, I don’t believe the right product for fixed wing air ambulance repatriations is on the market yet, thus we have taken the approach of designing our in-house training system, which is in alignment with our dedicated medical training department SimAirlec, combining VR and real-life scenarios with the help of our CAE Apollo mannequin.”

When it comes to the different types of simulations used in air medical training, a common theme is the creation of realistic scenarios that will not only benefit the team, but will also have a keen focus on safety. “Our trainers use their years of flying experience to create realistic scenarios. LifeFlight utilises flight data monitoring to increase flight safety and operational efficiency as part of our preventative safety approach,” Elliot told AirMed&Rescue. Training is tailored to the specific crew member in question and can incorporate various elements as desired, as Riesen articulated: “Moving people and objects can be used to recreate scenarios with possible critical incidents. We can set up specific scenarios to promote crew competencies and improve mission safety." For Airlec, a variety of unusual scenarios are used across a range of mission components: “In collaboration with SimAirlec we provide training environments for medical professionals in the aeromedical and hospital world,” confirmed Tiba. “We can train in airplanes, ground ambulances as well as hospitals, which allows us to cover all parts involved in a mission.”

Being able to control the environment and ensure safety is a key benefit of using VR in aircrew training as opposed to training crew in operational aircraft, as well as the ability to create scenarios that would be difficult to replicate in real life

Being able to control the environment and ensure safety is a key benefit of using VR in aircrew training as opposed to training crew in operational aircraft, as well as the ability to create scenarios that would be difficult to replicate in real life. Using VR, crew members in training can be exposed to different challenging scenarios, finessing their skills without being exposed to danger so that when they encounter future challenging situations, they are prepared. “Crews can practice handling challenges, such as difficult weather conditions, equipment issues and in-flight emergencies – all from the safety of the ground,” stated Elliot. “It would typically be unlikely crews would be able to face so many of these challenges while training in an actual aircraft. For example, trainers can create a demanding VR scene in the aircrew sim, involving wild weather, hard-to-find landing sites and obstacle avoidance. While in the flight simulator, pilots can rehearse extreme events that simply cannot be replicated in a live aircraft, such as engine failures and tail rotor failures. While some of these challenges are unlikely to actually happen, experience in navigating them safely significantly strengthens our crews’ ability to respond, when they’re called on missions.”

Riesen also noted the advantage VR affords of enabling a unique, safe training environment: “Our system enables crews to train at night and in difficult weather conditions at the limit of what is possible. Critical situations that cannot be trained in reality, such as possible incidents during helicopter hoist missions, can also be practiced in the simulator. This is done in a safe environment without any risk for the crew,” he told AirMed&Rescue.

Another important advantage of VR is the flexibility it affords, providing the ability to stop and start training as required, as well as replaying parts of procedures. This eliminates the stress and pressure from training, enabling trainees to really soak up what they are experiencing and have the capacity to take note of the finer details. “The ability to pause the VR sequence, replay it or slow it down provides the comfort of stress-free simulation and focus on minor details, which would otherwise be overlooked,” Tiba highlighted. “Reviewing procedures while not being the one performing allows for the trainee to focus on details and processes without the stress and pressure that come with being in a real life or training situation.” Elliot agrees: “VR also allows trainers to stop and start scenarios as needed, as well as giving crews the opportunity to repeat the mission. In both of our simulators, the scenario can be recorded and played back, so the trainee can see where they excelled and where they may need to improve.” In addition, it is possible to quickly change between scenarios, as Tiba explained. “Depending on the scenario, VR also allows for you to quickly change environments, for example switching from a hospital setting to an in-flight scenario, which is something that is hard to achieve in a real-life training simulation.”

Using VR, trainees can view scenarios and environments from different perspectives to really gain an accurate view of what’s occurring. “We focus on different VR perspectives in our training strategy, which is a massive advantage as the procedures can be viewed from different angles – for example an overview from the top, a view from the operating/acting crewmember and a side-line view, e.g. from the point of view of an assistant. This allows for all aspects of the procedure to be thoroughly observed and trained,” Tiba told AirMed&Rescue. Given that VR is so immersive, it can closely mimic real life, providing accurate and realistic preparation, as Tiba explained: “It provides you with a first-person angle, which allows for trainees to act out the procedures as they would be performing them in a real-life scenario”. Riesen agrees: “VR has the great advantage of fully immersing the crew in the scene being trained. Whether in helicopter pilot training or practicing helicopter hoist operations in standard HEMS crew configuration,” he told AirMed&Rescue. “Our technology includes a pose tracking of the crew member to represent the trainee’s movements in the virtual world and a highly dynamic motion platform. With the entire system, we create a full-body immersion. The person therefore dives completely into the scenery, which significantly increases the sustainability of the training. This is also the case in an operation performed close to the ground.”

The use of VR in the air medical sphere is still in the early days, but it is clear that it holds huge potential. In the future, new training solutions and products will be developed and the full capability is likely to be realised. “While we have seen an increase of VR training opportunities for first responders and especially rotary wing-based programmes, we have yet to see more products coming out for the fixed wing providers and especially the secondary transport segments,” Tiba said. “We are looking forward to developing our own solutions and we’ll be sharing the products with our fellow providers. Generally speaking, I do support any innovation that enhances the training possibilities for air medical crews as there are many highly complex procedures and risks involved. So, I’m very excited to see what the future brings.”

VR holds great potential for air medical crews, affording the opportunity for immersive and safe training and enabling trainees to be exposed to situations that are otherwise difficult to recreate. It also allows trainee crew members to rehearse and repeat scenarios, as well as review their efforts and apply feedback in order to improve. There is potential to enhance training using VR, strengthening the ability of crewmembers to respond to different situations and honing their ability to adapt and think quickly. With accessible VR solutions on the horizon that are likely to become increasingly common, options are expanding and different training systems are being developed. In the future we are likely to see more VR solutions coming to the fore and being adopted by HEMS and SARS crews to optimise training. Developments are underway and the experts consulted by AirMed&Rescue are confident of the potential applications of VR in this sector. “We see tremendous potential of VR technology in the training of HEMS crew. This has persuaded Airbus, among others, to enter into a cooperation agreement with VRM-Switzerland to promote flight safety,”Riesen concluded.