Abstract

Introduction: Virtual reality (VR) technologies have rapidly advanced and offer increasingly higher fidelity visually immersive learning environments. Several studies have shown promise for using VR in medical education. This pilot study evaluates the feasibility of using a novel VR trauma simulator that can function without an instructor, assessing potential challenges with the technology, perceived realism of the simulation, side effects experienced while completing the simulations, and overall perception of training utility from end-users.Methods: This was a single-center prospective cohort study completed at Madigan Army Medical Center Emergency Department. Participants were enrolled using convenience sampling. They completed surveys before and after completing a trauma simulation. Each participant underwent a 10-min simulation orientation and subsequently completed a self-directed trauma simulation involving massive hemorrhage, tension pneumothorax, or airway obstruction case. The simulation utilized a gaming laptop and a Microsoft Mixed Reality© headset and controllers. Survey data was analyzed using descriptive statistics and subgroup analyses.Results: Seventeen participants were enrolled and completed pre-and post-surveys. Study participants were predominantly male and represented all clinical roles in the emergency department (ED). Overall, participants indicated the training environment felt realistic (AV 8.3/10, SD 1.4, 95% CI 7.6, 8.0) and supported further use of this technology in training (AV 9.3/10, SD 0.99, 95% CI 8.8, 9.8). There was a statistically significant correlation between participants who responded, “I would support further use of this technology in my training” (likert greater than 8/10) and several other responses. Individuals who supported further use of VR in training were more likely to have fewer years of clinical experience, have more experience with 2D (desktop) computer training, reported realistic clinical changes within the simulator, indicated the environment was realistic, and supported the addition of VR to mannequin-based training.Conclusion: The results indicate it may be possible to create realistic dynamic VR simulations that function without an instructor, and that medical personnel may be supportive of integrating VR technology into medical education. This seems most likely for younger individuals, with less experience, who have found computer based medical training helpful in the past. Future research could focus on methods to minimize side effects, and how VR technology can best augment current training techniques and curricula.

Highlights

  • Virtual reality (VR) technologies have rapidly advanced and offer increasingly higher fidelity visually immersive learning environments

  • Individuals who supported further use of virtual reality (VR) had an average (AV) of 6.3 years experience (SD 4.0, 95% confidence interval (CI) 3.9, 8.7) versus those that did not support further use who maintained an average of 14.8years experience (SD 12.2, 95% CI -4.0, 34) (p-value 0.0306)

  • Participants were asked what other instructorless VR cases might be useful (Table 8) and they indicated future scenarios could include air/land transports, sick medical patients, prolonged field care, and individual procedures such as foley catheter placement and intubation. The results of this pilot study indicate it may be possible to create realistic dynamic VR simulations that function without an instructor, and that medical personnel may be supportive of integrating VR technology into medical education, those earlier in their career

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Summary

Introduction

Virtual reality (VR) technologies have rapidly advanced and offer increasingly higher fidelity visually immersive learning environments. Effective training for HALO clinical situations can be resource-intensive with barriers including prohibitive cost of high-fidelity equipment, lack of scenario reality, and need for significant faculty training and support. VR technologies have rapidly advanced, allowing the creation of high-fidelity immersive environments without the need for expensive mannequins and dedicated simulation space and faculty. VR systems can utilize headsets paired with controllers that allow interaction with the environment and some haptic feedback. These systems are powered by a gaming laptop with minimal space requirements and do not require internet connectivity. Several barriers have historically limited the widespread utilization of VR in medical training, including developing the necessary VR training programs, the technical knowledge required for the use, cost-effectiveness, and the educational value of the scenarios

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