Razavi Journal of Medicine

Razavi Journal of Medicine

A Virtual Reality-Based Software for Teaching and Assessing Disaster Triage: Design, Implementation, and Evaluation

Articles in Press

Document Type : Original Article

Authors
Ahmad Mahrooghi 1
Mahdi Foroughian 2
Bita Abbasi 3
Seyed Reza Habibzadeh 2
Raheleh Ganjali 4
Navid Kalani 5
Hamidreza Reihani 2
Reza Akhavan 2
1 Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
2 Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Department of Radiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 Clinical Research Development Unit, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
5 Research Center for Social Determinants of Health, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
10.30483/rjm.2026.254715.1479
Abstract
Background: Disasters cause extensive human casualties and disrupt communities, making triage a crucial component of crisis management. The START triage method rapidly assesses casualties and assigns them to color-coded categories, making it widely used in mass-casualty incidents. Traditional training lacks a stressful environment for skill assessment, while physical drills are costly. Virtual Reality (VR) provides an innovative, cost-effective solution by simulating crisis scenarios and enabling repeated practice.
 
Objective: This study aimed to design and evaluate a VR-based software for teaching and assessing the START triage.
 
Methods: This quasi-experimental pre-test and post-test study involved developing a VR-based crisis simulation software featuring Imam Reza Shrine and four culturally adapted casualty characters. After validation by emergency medicine specialists, 43 medical interns and 24 emergency medicine residents participated. All watched a START triage training video, completed a 10-question pre-test, and completed the Technology Readiness Index. They were randomly assigned to two groups: the control group received traditional training, while the intervention group practiced triage on four virtual cases with feedback. A post-test and Likert-scale satisfaction survey followed.
 
Results: The VR group had significantly higher post-test scores (P<0.05). Participants with moderate to high VR technology readiness reported greater satisfaction than the control group.
 
Conclusion: VR-based training enhances START triage learning and user satisfaction, making it a promising alternative to traditional methods.
Keywords
Disaster management
START triage
Virtual Reality
Medical education
Technology acceptance

Acknowledgements: The authors would like to express their gratitude to the participants for their invaluable cooperation and support throughout the study.

 

Availability of data and materials: The data that support the findings of this study are available from the corresponding author upon reasonable request.

 

Conflicts of interests: The authors declare that they have none.

 

Consent for publication: Not applicable.

 

Ethics approval and consent to participate: The Mashhad University of Medical Sciences ethics committee approved the study protocol under IR.MUMS.IRH.1401.066, which complies with the Declaration of Helsinki. Written informed consent for publication of their clinical details and clinical images was obtained from the patient.

 

Financial disclosure: No financial support was received for this study.

 

Author contributions: A.M.: Contributed to the conception of the work, revising the draft, approving the final version of the manuscript, and agreeing on all aspects of the work; M. F. and N.K: contributed to the critical revision, and approval of the final version of the manuscript; B. A. and R. G.: Contributed to the conception and design of the study, critical revision, and approval of the manuscript's final version; H.R.R. and R.A: Contributed to the conception and design of the study, drafting of the manuscript and critical revision, and approval of final version.

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 17 March 2026