TacMedVR: Immersive VR Training for Tactical Medicine—Evaluating Interaction and Stress Response

Abstract

This paper presents the development and evaluation of a virtual reality (VR) training simulation for tactical emergency medicine, created in Unity and optimized for the Meta Quest 3 headset. The simulation places users in a high-stress scenario inspired by real knife attacks and incorporates natural hand tracking for interaction. Core training elements include triage, bleeding control, and communication with victims and bystanders. A qualitative study with ten participants, all with prior first aid or tactical medical training, explored three key research questions: (1) To what extent does the realistic recreation of real-world events affect trainees' perceived psychological stress and sense of immersion in virtual reality simulations? (2) How do hand tracking and traditional controllers compare in terms of usability? (3) How is VR perceived as a complementary or alternative method to conventional training? Thematic analysis revealed that visual and auditory realism enhanced immersion but did not consistently increase perceived stress. Hand tracking was considered intuitive but occasionally unreliable. Participants generally viewed VR as a valuable complement to traditional training, particularly for practicing workflows and rapid decision-making under pressure. The results underscore VR's potential as a scalable, engaging, and safe tool for preparing responders for high-threat environments.