Mixed Reality vs Virtual Reality for Medical & Defence Training: The Complete 2025 Guide

Why Mixed Reality is an alternative to VR in military, aeromedical, EMS, paramedicine and clinical simulation.

Introduction

Training in high-risk environments, combat, aeromedical evacuation, emergency medicine, special operations, and frontline EMS requires realistic, hands-on practice with real equipment, real decision-making pressure, and true-to-life environments.

Until now, many organisations have adopted Virtual Reality (VR) simulation as an alternative to expensive live exercises. VR has its purpose and benefits, but its limitations are becoming increasingly apparent for medical training.

• No ability to use real equipment

• No tactile realism

• Controller-based interfaces

• Low-fidelity visuals

• Poor skill transfer

• Minimal multi-user realism

• No actual muscle-memory development

• Not suitable for mission-critical training

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In 2025, the global training landscape is shifting from VR to Mixed Reality (MR), especially with the introduction of high-fidelity headsets like the Varjo XR-4.

This guide explains exactly why.

What Is Virtual Reality (VR)?

VR places the user inside a fully digital environment. Everything is computer-generated:

• Digital hands

• Digital equipment

• Digital patients

• Digital aircraft or vehicles

• Digital lighting

• Digital physics

VR relies on controllers or hand-model approximations, making it inherently limited for fine motor skills or the use of real-world equipment use.

Where VR works:

• Introductory training

• Cognitive walkthroughs

• 3D visualisation

• Low-stakes simulations

• Rehearsal of basic concepts

• Procedures and decision making

Where VR fails:

• Medical procedures requiring dexterity

• CRM / Human Factors

• Aircraft cabin constraints

• Real equipment usage

• Interoperability between different equipment and services

• Care under fire

This is why organisations began searching for a more realistic alternative.

What Is Mixed Reality (MR)?

Mixed Reality blends the real and virtual worlds into a single training environment.

In MR:

• Learners see their real hands

• Learners use real equipment (medical tools, monitors, radios, weapons, manikins)

• The headset overlays a photorealistic virtual environment around them

• Real and virtual objects interact accurately

• Multi-user teams operate in the same synthetic space

BlueRoom’s MR system uses:

Varjo XR-4 - the world’s most advanced MR headset

• Human-eye resolution

• Depth-accurate occlusion

• Zero-motion-blur passthrough

• HDR photorealism

• Ultra-low latency

• Perfect hand tracking

• True fusion of virtual & real worlds

This enables trainees to perform actual tasks in a virtual environment:

• Insert an airway

• Control massive haemorrhage

• Apply a tourniquet

• Operate aircraft cabin equipment

• Perform TCCC under fire

• Use a real or simulated weapon

• Treat a real manikin

• Communicate using radios

• Work inside virtual aircraft cabins

VR cannot do this.

Why Mixed Reality Is Replacing VR in 2025

Real Equipment, Real Hands and Real Muscle Memory

VR uses controllers, whereas mixed reality uses your real hands.

VR uses virtual objects whereas MR uses real objects.

This is essential for:

• Paramedics

• Doctors

• Anaesthetics

• Aeromedical teams

• Combat medics

• Critical care

• Search and Rescue (SAR)

• Police tactical medics

• Special operations

In MR:

1. You feel the weight of tools.

2. You hear the click of equipment.

3. You manipulate real objects.

4. You perform tasks exactly as you would in real life.

In VR:

You are reliant on controllers or hand tracking

True Environmental Realism

MR use high-performance computers to ensure the highest quality environments which feel real:

• Full-scale aircraft

• Realistic lighting

• Sound

• Constrained environments

• Terrain

• Weather

• Hazards

Airframe-Agnostic Reconfigurability (Unique to MR)

BlueRoom supports multiple aircraft, combat zones, pre-hospital scenes, hospitals and more. There is no need for physical environments or fuselage replicas.

Mixed Reality vs Virtual Reality: A Full Comparison Table

Feature	Mixed Reality (BlueRoom)	Virtual Reality
Real hands	✔	✘ (controllers)
Real equipment	✔	✘
Real manikins	✔	✘
Real weapons	✔	✘
Aircraft cabins	✔	✘
Airframe-agnostic	✔	✘
Multi-user realism	✔	Limited
Real muscle memory	✔	✘
Photorealistic passthrough	✔	✘
Stress & biometric tracking	✔	✘
Suitable for TCCC	✔	✘
Suitable for aeromedical	✔	✘
Team-based CRM	✔	✘

Why Medical, Defence and EMS Organisations Are Transitioning to MR

Because MR solves the biggest training gaps:

✔ Limited access to aircraft

✔ Inability to rehearse in real environments

✔ High cost of live training

✔ Safety limitations

✔ Minimal realism in VR

✔ Reliance on digital controllers

✔ Inaccurate procedural practice

MR provides:

• Deeper immersion

• Better skill transfer

• Higher student engagement

• Safer high-stakes practice

• Reduced need for aircraft

• Better team-based rehearsal

• More realistic medical scenarios

• Custom mission rehearsal

• Unlimited reconfigurability

BlueRoom: The World’s Most Advanced MR Training Ecosystem

BlueRoom offers:

✔ Mixed Reality Aeromedical Simulator

✔ Mixed Reality Full Mission Simulator (MR-FMS)

✔ Mixed Reality Tactical Combat Casualty Care

✔ BlueRoom Mission Control

✔ BlueRoom Biometrics

All powered by Varjo XR-4 and BlueRoom’s custom MR integration software.

Case Study: MR Aeromedical Training vs VR Aeromedical Training

Mixed Reality (BlueRoom)

• Treat a real manikin in a virtual C-130J

• Use real airway equipment

• Use real monitors

• Apply real tourniquets

• Perform cabin workflow

• Train CRM with multi-crew

• Photorealistic aircraft cabin

• Stress-inducing environmental cues

Virtual Reality

• Controllers/hand tracking

• Digital tools

• Lower fidelity scenes

• No physical constraints

• No tactile realism

Case Study: MR TCCC vs VR TCCC

Mixed Reality (BlueRoom)

• Real weapons

• Real tactical procedures

• Real medical tools

• Real manikin

• Smoke, lighting, explosions

• Care under fire

• HOT/WARM/COLD transitions

• Multi-role teams

VR

• Controller-based

• Simplified scenes

• No real tools

• No weapon handling

• No tactile realism

• Requires controllers or hand tracking

When Should Organisations Use VR Instead of MR?

VR is appropriate for:

• Early orientation and familiarisation

• Low-stakes cognitive walkthroughs

• Basic decision training

• Procedure-based training

• Basic concepts

  
  

But VR is not appropriate for:

• Clinical skills

• TCCC

• Aeromedical workflows

• Multi-crew aviation

• Search and rescue

• CRM

• Specialist care

• Care under fire

• High-stakes simulation

Frequently Asked Questions

Is Mixed Reality better than VR for medical training?

Yes, if your objective is to practice fine motor skills using real equipment.

Can MR simulate an aircraft cabin?

Yes. MR can load full-scale airframes of fixed and rotary wing platforms.

Can VR simulate care under fire?

VR can simulate visuals; MR enables real-world tasks in a live-fire environment.

Is BlueRoom used by the Army?

Yes, BlueRoom is used by Royal Australian Air Force and Royal Netherlands Army along with others.

Does MR require a physical fuselage?

No, BlueRoom is airframe-agnostic and allows for training within any synthetic airframe using any equipment.

Which headset is best for MR?

Varjo XR-4 is used exclusively by BlueRoom.

Does MR provide better skill transfer than VR?

Yes, assuming the skill transfer required is a hard skill requiring the use of ones real hands and physical tools.

Is MR the Future of Simulation Training?

VR was an important step in training evolution, but 2025 belongs to Mixed Reality.

BlueRoom’s MR ecosystem enables:

• Realism

• Safety

• True skill transfer

• Multi-role coordination

• Airframe-agnostic mission rehearsal

• Cost-effective high-complexity training

• The highest fidelity training available

For military, aeromedical, EMS, university and hospital environments, Mixed Reality is not a “nice-to-have”. It is a fundamental shift in training capability.