A preliminary study of a novel emergency department nursing triage simulation for research applications

Abstract

BackgroundStudying the effect on functioning of the emergency department of disasters with a potential impact on staff members themselves usually involves table top and simulated patient exercises. Computerized virtual reality simulations have the potential to configure a variety of scenarios to determine likely staff responses and how to address them without intensive utilization of resources. To decide whether such studies are justified, we determined whether a novel computer simulation has the potential to serve as a valid and reliable model of on essential function in a busy ED.MethodsTen experienced female ED triage nurses (mean age 51) mastered navigating a virtual reality model of triage of 4 patients in an ED with which they were familiar, after which they were presented in a testing session with triage of 6 patients whose cases were developed using the Emergency Severity Index to represent a range of severity and complexity. Attitudes toward the simulation, and perceived workload in the simulation and on the job, were assessed with questionnaires and the NASA task load index. Z-scores were calculated for data points reflecting subject actions, the time to perform them, patient prioritization according to severity, and the importance of the tasks. Data from questionnaires and scales were analyzed with descriptive statistics and paired t tests using SPSS v. 21. Microsoft Excel was used to compute a correlation matrix for all standardized variables and all simulation data.ResultsNurses perceived their work on the simulation task to be equivalent to their workload on the job in all aspects except for physical exertion. Although they were able to work with written communications with the patients, verbal communication would have been preferable. Consistent with the workplace, variability in performance during triage reflected subject skill and experience and was correlated with comfort with the task. Time to perform triage corresponded to the time required in the ED and virtual patients were prioritized appropriately according to severity.ConclusionsThis computerized simulation appears to be a reasonable accurate proxy for ED triage. If future studies of this kind of simulation with a broader range of subjects that includes verbal communication between virtual patients and subjects and interactions of multiple subjects, supports the initial impressions, the virtual ED could be used to study the impact of disaster scenarios on staff functioning.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2337-3) contains supplementary material, which is available to authorized users.

Effects of Virtual Reality Simulation on Worker Emergency Evacuation of Neonates

“…Current evidence supports the use of VRS as a training method, but only a few studies have used experimental designs. [25][26][27][28][29][30] The reviewed literature related to VRS used in overall evacuation training is predominately focused on model crowd response. This research supports the findings of Ribeiro, Almeida, and Rossetti et al 11 and Garrett and MacMahon, 12 who effectively used VRS to train participants in evacuation.…”

“…The use of VRS enhanced performance. Current evidence supports the use of VRS as a training method, but only a few studies have used experimental designs 25 30 The reviewed literature related to VRS used in overall evacuation training is predominately focused on model crowd response.…”

Cost-effectiveness of a video game versus live simulation for disaster training

“…Simulation has become a standard of education and training in the current medical environment for multiple reasons, including patient safety initiatives as well as practising high stakes low frequency events such as disaster triage training. 25 34–37 Over the past decade, multiple studies have been published looking at effectiveness, cost analysis and financial savings from simulation training. 38 For example, studies in regular simulated paediatric mock codes and simulation-based obstetric emergencies have evaluated patient outcomes as well as the ultimate financial savings to demonstrate value and necessity in such training.…”

Use of high‐fidelity simulation technology in disasters: an integrative literature review

“…9 All articles only covered a disaster's preparedness phase and analyzed computerized virtual reality simulation with the intent of assessing its effectiveness for professional degree-seeking student (n = 4, 66.6%) and first responder (n = 2, 33.3%) training for natural disaster/ mass casualty incident triage or chemical/radiological decontamination. [15][16][17][18][19] Computerized virtual reality simulation was shown to be safe and cost-effective for preparing for mass casualty incidents or epidemics given its minimal resource utilization, training site flexibility, and ease of reconfiguring for training disaster-specific low-volume/highrisk skills that must be performed with accuracy. 15,16,18 Full-scale simulation combines mock injured high-fidelity manikins in a high-fidelity environment with digital videorecording and wireless communication to create realistic disaster conditions.…”