Virtual Reality Disaster Health Preparedness Training


The National Library of Medicine's (NLM) Virtual Reality Disaster Health Preparedness Training program leverages simulation, computer gaming and instructional design technologies to develop training methods and tools to support health disaster preparedness. The program intends to help organizations and crisis management teams to train more frequently and effectively, and enhance preparedness.
Important: NLM is implementing a new organizational Long Range Plan. As an effect of refocusing resources on new priorities, our disaster-related R&D programs had to be discontinued. The applications listed below are functional, but experimental. They are provided as-is and we are currently unable to provide technical support.

This page is no longer being updated.

Virtual HICS/ICS Training

We created a software toolkit for conducting collaborative, scenario-based Incident Command System (ICS) exercises. These tools were developed as part of our efforts to develop training methods that can yield better instructional benefits than traditional tabletop exercises, accommodate new instructional requirements and constrains, and leverage recent technical innovations.

More specifically, the toolkit address the following key concerns regarding traditional tabletop exercises:
•    Maintaining trainee engagement during exercises.
•    Enabling remote participation in collaborative exercises.
•    Collecting detailed exercise execution data for evaluations.
•    Maintaining low exercise implementation and management costs.
•    Providing high scenario realism.
•    Enabling practicing the use of real life information, communications and decision-making tools.
•    Reducing the impact of training activities on day-to-day business activities.
•    Exploiting recent development in computer simulations, gaming systems and other related technologies.

The toolkit builds on research and experimentation on a variety of training platforms and technologies, including public online virtual worlds, virtual reality and ad-hoc simulation tools. 


Our Virtual Incident Command System Exercise (VIX) toolkit enables ICS teams designing, analyzing and practicing ICS scenarios to develop standards-based incident management skills and proficiency.


NLM’s Virtual ICS Exercise System (VIX-S) components 
Figure 1: NLM’s Virtual ICS Exercise System (VIX-S) components. (click for larger image)


See the following User’s Guide for a detailed explanation of this toolkit: (PDF, 4.3 MB)


The toolkit has three components:


1. Exercise Simulator 

We developed a custom multiplayer videogame-like application that enables a team of up to 20 trainees, exercise controllers and observers to run an ICS exercise and practice a disaster scenario using their personal computers. The application collects detailed data automatically for exercise evaluation. The simulator can handle exercise injects in the form of messages, graphics and live, interactive web pages. An in-game communications tool enables players exchanging information that is automatically captured for post-exercise evaluation. For a complete description of these and many other features, see the User’s Guide. 
The application was designed to run on a personal computer with MS windows, and can be downloaded from this link:   (1.01 GB)
 Follow the instructions in the User’s Guide to setup and use the application. The Simulator includes an example exercise script.



Virtual emergency operations center simulator 
Figure 2: Virtual emergency operations center simulator. November 2019. (click for larger image)


Related resources: 

NLM In Focus: Virtual Training for Real-World Disaster Management. 

NLM In Focus: Every Minute Counts 

Virtual Hospital Incident Command System Training (YouTube video) 


2. Exercise Design Tool

We developed an experimental tool that enables trainers to design Master Scenario Events Lists (MSELs), also known as scenario scripts, which can be used to conduct collaborative exercises with our VIX Simulator application. The MSEL Designer application was originally developed to run on a web server, but the installer integrates a set of tools that enable it to run on a regular personal computer with MS Windows. The installer can be downloaded from this link:   (141 MB)
Follow the installation and usage instructions on the User’s Guide. See “Related resources” below for other useful downloads.



SEL Designer interface panel 
Figure 3: SEL Designer interface panel. (click for larger image)


Related resources:
The Designer application’s installer does not include example scenario scripts. Following is an example MSEL that can be imported into the Designer (see instructions in the User’s Guide) and used as a template to build other virtual ICS/HICS exercise scenarios: Disease Outbreak  (12.2 MB)

The following Power Point file was used to create scenario injects for the example MSEL and illustrates how to make scenario inject materials: scenario slides.pptx  (31 MB)


3. MSEL Analyzer

The VIX Analyzer application enables analyzing a MSEL created with the MSEL Designer tool and viewing a number of metrics useful for understanding and enhancing exercise scrips. The MSEL Analyzer can run on any MS Windows computer and can be downloaded from this link:  (539 KB)
See the User’s Guide for further information.



MSEL Analyzer tool, Simulator tab 
Figure 4: MSEL Analyzer tool, Simulator tab (click for larger image)




Virtual Highly-Infectious Disease Emergency Management (HIDEM) – Doffing Practice Tool

The Virtual HIDEM Personal Protective Equipment (PPE) Doffing application can help patient care personnel to develop proficiency on PPE doffing skills. This training tool follows CDC guidelines for the management of Ebola patients (as of August 2015), but it is applicable to other infectious diseases. The application resembles a two-player 3D video game and enables two healthcare professionals practicing PPE doffing skills in a collaborative fashion through interactive simulations and videos.

The application requires two computers running the same program and connected to a common local area network (LAN). See the video link in “Related resources” for a demonstration.

The application can be downloaded for MS Windows or Apple macOS X from the links below. Just un-zip the file and run the application – no installation is required:

MS Windows version: (1.4 GB)

Apple OS X version: (1.4 GB)



HIDEM PPE Doffing application 
Figure 5: HIDEM PPE Doffing application. (click for larger image)


Related Resources
Dass S., Cid V., Barnieu J., Cummings P. A Cognitive Task Analysis for an Emergency Management Serious Game. I/ITSEC 2016. 

HIDEMM YouTube video:

Computer Games for Awareness

Leveraging technical skills and resources developed in our virtual training R&D program, summer student interns developed a mobile game for Android devices. This is not a training application. Its development enabled students to practice and learn simulation techniques in an engaging way, and develop an application that can help promote a NLM product for crisis management. 
The game draws inspiration from WISER, the Wireless Information System for Emergency Responders, one of NLM’s prominent apps for emergency response professionals (see The app is a 2D platformer game in which a first responder must survive dangerous, often toxic, challenges, some requiring the use of an included WISER-like information system. The game challenges the player’s speed (completion time) and/or thoroughness (points collected) to complete HAZMAT response missions. You can download the Android game from this link:  (232 MB)
To install the game, download the above APK file to your Android device, make sure your device is configured to accept content from “unknown sources”, then find the file in your device and tap on it to install it.



Screenshots from WISER Response game 
Figure 6: Screenshots from WISER Response game. November 2018. (click for larger image)


Frequently Asked Questions

Q: Will NLM maintain these applications? 

A: Unfortunately, these experimental tools, and the originating R&D program that supported them, have been retired. We cannot guarantee that we will maintain these programs updated in the future. 

Q: Are these tools free to use?

A: All NLM resources and tools are free to use.


Q: Can we use these ideas to create our own training applications?
A: Yes. NLM developed these tools enable NLM and others to explore the involved methods and resources. They are not production-quality applications. Developers are encouraged to build better applications based on these ideas. However, at this moment we are not able to share our applications’ source code, as they include proprietary code licensed from commercial vendors.

Q. Who can I contact to obtain more information?

A. You can contact us at