The National Institute for Occupational Safety and Health (NIOSH), the U.S. federal agency charged with making research and recommendations for the prevention of work-related injuries and illnesses, has tracked training and education for firefighters in the U.S. During the period 2001 to 2014, the U.S. Fire Administration reported that approximately 11% (150 out of 1396) of firefighter line-of-duty deaths were training-related. The leading causes of training-related deaths were heart attacks (55%) and traumatic injuries (28%). The remaining 17 % were due to other types of cardiovascular disease and miscellaneous circumstances. (NIOSH, 2017). The top three types of training activity that were associated with fatalities are physical fitness activities, apparatus and equipment drills, and live-fire exercises. (USFA 2015). Simulators with virtual reality could be a solution.