Challenges of and criteria for validating a physiology model within a TCCC serious game

Tactical Combat Casualty Care (TCCC) principles save lives on the battlefield but tend to stress established military medical training structures because of the need to train the entire force, thereby encouraging new large-scale computer-based training methods such as serious games. Since improper training would cause avoidable casualty deaths, important experimental efforts have been made to ensure the validity and reliability of these new methods and of their components. This survey of validation efforts attempts to identify best practice, challenges and limitations for proper design and rigorous validation of TCCC serious games and their virtual casualty pathophysiological simulation components, guided by the hippocratical requirement that new TCCC training methods must be more effective and reliable than traditional ones, in order for their large-scale use to be ethically acceptable (first, do no harm). TCCC serious game validation solutions are then deduced to guide our own TCCC serious game demonstrator design.