Digital simulations to enhance military medical evacuation decision-making

Background: The US military medical evacuation mission is responsible for expediently evacuating the battlefield ill and injured. Medical evacuation planning involves constructing a robust network of medical platforms and facilities capable of moving and treating large numbers of casualties. We introduce the first known medium to simulate these networks in an educational setting and evaluate both offline planning and online decision-making performance. The Medical Evacuation Wargaming Initiative (MEWI) is a custom-built, high-fidelity multiplayer simulation that models tactical-level medical evacuation operations. Methods: This study demonstrates the impact of simulation-based training on medical evacuation decision-making. We visualize performance data collected from two MEWI iterations executed in the US Army’s Medical Evacuation Doctrine Course. We consider post-simulation Likert-type survey data from participants and external observer notes to identify key planning decision points, document medical evacuation lessons learned, and quantify general utility. Results: The results highlight that participation in simulation-based medical evacuation scenarios substantially improves uptake of medical evacuation lessons learned and enhances cooperative decision-making. Discussion and Conclusion: MEWI is a substantial step forward in the field of high-fidelity training tools for military medical evacuation education. Our study findings offer critical insights into improving medical evacuation across the joint force.