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CyberTherapy & Rehabilitation, Issue 4 (2), Summer 2011.

CyberTherapy & Rehabilitation, Issue 4 (2), Summer 2011.

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Published by Giuseppe Riva
CyberTherapy & Rehabilitation Magazine (C&R), the official voice of the International Association of CyberPsychology, Training & Rehabilitation (iACToR - http://www.imi-europe.eu/ - http://iactor.ning.com/). iACToR is an international association that has been created with the goal of disseminating knowledge about exciting new findings being made to transform healthcare through the addition of cutting edge technologies. This publication will serve as a catalyst whereby society may rapidly benefit from the remarkable technological revolution that is occurring, with the ultimate aim of improving the quality of today's healthcare and helping to quickly disseminate research results.
CyberTherapy & Rehabilitation Magazine (C&R), the official voice of the International Association of CyberPsychology, Training & Rehabilitation (iACToR - http://www.imi-europe.eu/ - http://iactor.ning.com/). iACToR is an international association that has been created with the goal of disseminating knowledge about exciting new findings being made to transform healthcare through the addition of cutting edge technologies. This publication will serve as a catalyst whereby society may rapidly benefit from the remarkable technological revolution that is occurring, with the ultimate aim of improving the quality of today's healthcare and helping to quickly disseminate research results.

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Published by: Giuseppe Riva on Jul 22, 2011
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09/21/2013

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Issue 2 / 2011
Stress InoculationTraining forCombat Medics
and much more...
The Official Voice of iACToR
ISSN 2031 - 278
FEATURES:
Modeling and Simulation to SupportTraining of Combat Medics
p 14
New Applications for High FidelityPatient Simulation
p 20
COVER STORY:
 
ASK THE EXPERT
Robert Madelin
p 33
COUNTRY FOCUS:
Germany
p 42
 
Visually Realistic - Comfortable - Easy to UseDurable - Reusable - Tactilely Realistic 
INJURY CREATION SCIENCE
The Next Generation of Injury Simulation Today 
Prosthetic tissue, wounds, and life saving skills trainingdevices used in the training of medical professionals
• Cricothyrotomy Skills Trainer • Needle Decompression Skills Trainer • Bleeding Wound Skills Trainer • Amputation Skills Trainer • Burn Wound Skills Trainer • Odor Wound Skills Trainer 
Merging latest special effects technology with medical andmaterial sciences research to replace live tissue and training.Physiologically based research and developmentprogram focused on providing enhanced trainingcapabilities for medical professionals to include:
• Basic Life Support• Patient Assessment• Hemorrhage Control• Fracture Management• Shock Prevention & Treatment
CricothyrotomySkills Trainer Needle DecompressionSkills Trainer Bleeding WoundSkills Trainer 
 
Severe AmputationSkills Trainer 
 
Odor SimulationWound KitSimulated BurnWound Package
FOR MORE INFORMATION, CONTACT:Mark D. Wiederhold, M.D., Ph.D. FACPThe Virtual Reality Medical Center 858.642.0267 mwiederhold@vrphobia.comwww.vrphobia.com
 
1
Letter from the SecretaryGeneral and Editor-in-Chief
Professor Dr. Brenda K. Wiederhold
Dear Reader,Stress inoculation training (SIT) is a type of trainingused to prepare individuals for stressful situations andhelps diminish the potential for a negative psycholog-ical reaction. In cognitive-behavioral therapy, SIT is ac-complished through gradual, controlled, and repeat-ed exposure to a stressor. The goal behind thisexposure is to desensitize or “inoculate” the personto the possible stimuli of a stressful situation, avoid-ing a panic or “fight or flight” response to the realthing. This repetition allows the individual to calmlyand accurately accomplish the tasks at hand in a stress-ful environment. Developed in the late 1970s by Me-ichenbaum, controlled exposure to stress-related cuescontinues to be a key feature of resiliency training.Because SIT is a technique used to help harden indi-viduals to future potentially traumatizing stressors,it makes sense to use this method to help train thosewho must treat trauma patients. These personnelmust often perform in extremely stressful environ-ments, and optimum performance under such con-ditions requires effective management of physiolog-ical, psychological, and emotional responses tostressful stimuli. An acute stress reaction can occurduring exposure to exceptionally stressful events, re-sulting in extreme sympathetic nervous system arous-al and impaired performance. Longer-term reactionsto these situations can include acute stress disorder,Posttraumatic Stress Disorder (PTSD),and burnout.One method to attenuate or prevent these reactionsis Virtual Reality-enhanced SIT, in which personnel“experience” highly stressful situations in a virtualenvironment. Repeated exposure enables perform-ers to gradually become desensitized to stimuli thatmay initially elicit such strong physiological arous-al that performance is impeded (e.g., freezing un-der gunfire instead of moving a wounded soldier tosafety), and therefore, psychological trauma shouldbe less likely. Stress inoculation training is associat-ed with a reduction in anxiety and an enhancementin work-related performance. Preliminary results of a study by Stetz and colleagues showed that virtualenvironments do succeed in stressing medicsenough to produce an “inoculation” effect by in-creasing anxiety and dysphoria.There is evidence that SIT can reduce PTSD. In a2000 study by Deahl and colleagues, a group of 106male British soldiers preparing for a six-month tourof duty in Bosnia received a combination of pre-de-ployment stress training and post-deployment psy-chological debriefing. After deployment, participantsdemonstrated a drastically reduced incidence of PTSD and other psychopathology as compared tocontrols, approximately 10 times less than figuresreported from other military samples. In fact, thelevel was so low that it precluded any possible de-briefing effect.A recent Rand review of the evidence of effective-ness of various treatments for PTSD rated SIT as aLevel A intervention as of 2000, based on two well-controlled and two less well-controlled studies infemale sexual-assault survivors. Level A is the mostrigorous, defined as “Evidence is based on random-ized, well-controlled clinical trials for individualswith PTSD.”
“Preliminary results of a study by Stetz and colleagues showedthat virtual environments do succeed in stressing medicsenough to produce an ‘inoculation’ effect by increasing anxiety and dysphoria.
“Because SIT is a techniqueused to help harden individu-als to future potentially trau-matizing stressors, it makes sense to use this method tohelp train those who must treat trauma patients.”

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