JMIR Publications

ABSTRACT

Background:

Firefighters face stressful life-threatening events on a daily basis, requiring fast decision-making. To better prepare for those situations, training in realistic settings is paramount, but it can be harmful for the firefighters since errors can lead to harm or even death. Virtual Reality (VR) simulations provide the desired realism while enabling practice in a secure and controlled manner. Firefighters’ affective states are also crucial because this group is at higher risk among emergency workers.

Objective:

To assess the impact of simulated experiences in a sample of firefighters, this study pursues a multivariate approach, comprising cognitive performance, situational awareness, depression, anxiety, stress, adversity, post-traumatic stress disorder (PTSD) severity, and affective states. The efficacy of an innovative VR haptic system, exploring its impact on firefighter performance was also tested.

Methods:

In collaboration with the Portuguese National Fire Service School, 22 firefighters were submitted to two distinct immersive scenarios using the FLAIM Trainer VR system (a neutral and an arousing scenario), while recording physiological data. Baseline cognitive performance, depression, anxiety, and stress, adverse events as a firefighter and PTSD symptoms were evaluated. Positive and negative affective states were measured before, between and after each scenario. Situational awareness, sense of presence, ecological validity, engagement and negative effects resulting from VR immersion experience were tested.

Results:

Baseline positive affect was high (mean 32.4, SD 7.2) and increased after the VR tasks (Partial η2=0.52, Greenhouse-Geisser F1.82,32.78=19.73, P<.001). Contrarily, mean negative affect remained low (range 11.0-11.9) throughout the study (Partial η2=0.02, Greenhouse-Geisser F2.13,38.4=0.39, P=.69). Participants’ feedback on the VR sense of presence was also positive, reporting high sense of physical space (mean 3.9, SD 0.8), ecological validity (mean 3.8, SD 0.6) and engagement (mean 3.8, SD 0.6). Engagement was related to the number of adverse events previously experienced (r=0.49, P=.02) and to positive affect (after all VR tasks) (r=0.55, P=.02). Conversely, participants reported few negative effects (mean 1.6, SD 0.5). They correlated positively with negative affect (after all VR tasks) (r=0.58, P=.01) and with avoidance (r=0.70, P=.002), a PTSD symptom. Performance related to situational awareness was positive (mean 46.4, SD 34.5), although no relation was found to metacognitively perceived situational awareness (r=-0.12, P=.59).

Conclusions:

This study demonstrated that VR is an effective alternative to in-person training, as it was considered ecologically valid, engaging, and promoted positive emotions, with few negative repercussions. It further demonstrated how a VR setting can be used to test firefighters’ performance and their awareness of a situation. Further research is needed, namely to guarantee that firefighters with PTSD symptomatology are not negatively affected by VR. This study strengthened the evidence in favor of VR training and provides new insights on the emotional and cognitive impact it has on the trainee.