Austin/Travis County EMS came to us looking for a new training solution for their AMBUS personnel. The AMBUS is a highly specialized, bus-sized ambulance used for mass casualty events and natural disaster response. With only 13 AMBUS vehicles in the state of Texas, their current training consists of a once-per-year training on the equipment, supported by a powerpoint document.

For over 13 months, ATS observed their training and talking with EMT professionals in the field, identifying a number of pain-points:

AMBUS: At a glance


AMBUS vehicles in Texas


Deployments to natural disasters in 2017


Patients transported at a time

Increased time-on-task

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EMTs were concerned with the delay in care…

Lack of memory recall

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…and not remembering locations of items on the bus…

Reduced confidence

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…which increased stress and errors

With only 13 AMBUS vehicles in Texas, regular training is impractical and expensive

ATS designed a VR and AR system allowing EMTs to train anytime they wanted at their station house

AMBUS Vehicle exterior photo


Targeting these primary pain points: Time-on-task, memory recall, and confidence, ATS began designing a testable proof of concept to determine the best training solution for their needs. Utilizing current design thinking methodologies and rapid prototyping, we broke the project into a number of phases.

Feel free to explore the AMBUS

Phase 01


We started by documenting the entire Ambus in 360º. These spherical photos were then made into an interactive smartphone walkthrough of the vehicle, complete with opening drawers and content labels, allowing EMTs to explore the vehicle anytime and anywhere.

With this simple prototype, we were able to create a proof of concept that helped to validate the solution before any coding or 3D rendering was begun; saving time and budget.

Phase 02

Virtual Reality Training

In order to create a fully customizable training system, allowing for multiple scenarios, ATS created a fully 3D rendered Ambus environment.

This environment resulted in a truly immersive experience, allowing for Austin/Travis County EMTs to test a number of training scenarios and collect data to track trainee improvement in our three core areas of memory recall, time-on-task, and trainee confidence.

Phase 03

Augmented Reality Training

In order to improve the ability for the EMTs to take advantage of physical memory when training in the AMBUS, we created an Augmented Reality environment using Microsoft Hololense.

This environment gives the EMTs the unique ability to use any hallway or large room in their station to project a holographical representation of the AMBUS with all of the objects inside. The projection is to scale, meaning, if it takes the EMT 5 steps to reach a particular drawer in AR, they take the same number of steps in the real bus, utilizing their physical memory.


Testing was conducted with volunteer cadets from Austin/Travis County EMS. These trainees were divided into three groups: those that received traditional AMBUS Training, those that received our VR Training, and those that received our AR Training.

All three groups of trainees were tested 1 week later in the real AMBUS to determine how much improvement they had in the three domains of memory recall, time-on-task, and confidence level.

Trainees were divided into 3 groups:


Traditional Training


VR Training


AR Training


At the end of the 1 week training, all three groups were put through a test on the real AMBUS. The cadets were tested on two variables: time-on-task and number of errors. In addition, all three groups were asked to fill out an anonymous questionnaire to gauge their confidence level, among other variables.

``This is the coolest thing I've done in my life!``

– EMS Cadet

The results were significant:

Improved Memory Recall

45% increase in memory recall

Increased ability to remember object locations, compared to traditional training

Improved Time-on-Task

29% decrease in time on task

Decreased time-on-task, compared to traditional training

If that sounds impressive, think about what ATS can do to augment your training needs