Army first responders, specifically Combat Medics and Combat Lifesavers, provide medical intervention while in the field. Didactic as well as hands-on training helps to prepare these first responders, and one module they receive involves bleeding control. First responders are taught to use the Combat Application Tourniquet® (CAT® ) to stop bleeding from limbs subjected to severe injury such as amputation, gunshot, or severe lacerations. A training aid like the Multiple Amputee Trauma Trainer™ (MATT™) simulator provides tourniquet training using a lifelike bilateral lower limb amputee. In addition, MATT™ combines movement and resistance while the first responder applies the tourniquet, mimicking conditions one would see in a real situation. This research describes tourniquet history, appropriate usage, field tourniquet review, surgical tourniquet, CAT® bleeding intervention procedures, bleeding physiology and complications, prehospital tourniquet use in recent conflicts, medical simulation fidelity, and a review of the value of animatronic movement during tourniquet simulation-based training. I then evaluate the effectiveness of animatronic movement during tourniquet training using the Advanced MATT in an experiment using Army first responders. The control group experienced no movement while the experimental group experienced movement when applying a tourniquet during the lab-training. Each group then alternately experienced Advanced MATT movement during an immersive scenario along with fog, strobe lights, and battle sounds. It was hypothesized that 1) In the immersive scenario, the experimental groups (i.e., those who were trained on a moving simulator) would have a faster reaction time as compared to those participants who did not receive training on the moving Advanced MATT simulator; 2) In the iv lab-based training, the experimental groups would have a slower reaction time; 3) In the immersive scenario, the experimental groups would have a faster tourniquet application time when subjected to movement while in the lab-based training, but the experimental groups would also have a slower tourniquet application time when initially subjected to movement in the laboratory-based training; finally, 4, 5, and 6) Participants who completed lab-based tourniquet training on the Advanced MATT simulation with animatronic movement would report higher perceived realism scores than participants who complete the training on a static version of the Advanced MATT and participants who completed a tourniquet training immersive scenario on the Advanced MATT simulation with movement would report higher perceived realism, presence, and self-efficacy scores than participants who complete the training on a static version of the Advanced MATT. The empirical results show a significant overall training effect of the Advanced MATT simulator (with or without movement). For reaction time and tourniquet application time, involving simulator movement was significant over varying scenarios. A small reduction in reaction and tourniquet application time on the battlefield may be extremely beneficial on the battlefield. Participants who received movement generally gave more positive reactions than those who did not received movement, although these results failed to reach statistical significance. Participants who received movement, followed by a scenario without movement rated the subjective ratings the lowest, suggestive of the lack of movement. Furthermore, despite the order movement was received, no large drops in performance occurred in any condition, indicating that negative training was avoided

School shootings and emergencies have created the need for educators to be proficient in emergency response procedures; yet they do not always receive the requisite training. The lack of an established delineated training program for New Jersey, kindergarten to Grade 12 institutions has created a situation where educator preparedness varies immensely at schools. Numerous national events of targeted school violence have exemplified the need for quick and proper responses by educators to mitigate the tragic results until first responders arrive. The purpose and goal of this study was to assess educators’ perceptions and to determine the best practices in creating a comprehensive safety and security training program to prepare educators for school crises in order to offer a model for stakeholders to follow or gain ideas to improve their institution’s specific school safety and security emergency plans. Guided by the U.S. Department of Education’s best practices in developing high-quality school safety plans, this study analyzed the perceptions of 60 educators in one New Jersey kindergarten to Grade 12 school on the effectiveness of training. A mixed-methods approach, using a survey questionnaire and interviews, measured changes in the perceptions of these educators after the 15-week program. Data results included a revelation of the implementation of a comprehensive school safety and security plan with related training program resulted in a statistically significant increase in the perceptions of educators’ knowledge and abilities to respond effectively to school targeted violence and emergencies. These findings support the concept that best practices in the field of school safety and security management include appropriate and comprehensive school safety and security plans and training for educators to combat and mitigate school targeted violence and emergent events.