Evaluation of a Virtual Reality Simulator in Sustainment Training

Agazio, Janice; Pavlides, C; Lasome, Caterina; Flaherty, Norma J.; Torrance, Rebecca

doi:10.1093/milmed/167.11.893

Cited by 12 publications

(5 citation statements)

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“…The recent development of technologic advances in the area of medical education provides a powerful platform for advancing the cognitive and psychomotor skills of practitioners. A large number of computer‐based simulators have been introduced in teaching clinical practice 7,10–12 . Although many of these devices are highly realistic, their educational value is under investigation, especially in terms of their learning curve assessment and role within a training curriculum.…”

Section: Discussionmentioning

confidence: 99%

A Virtual Reality Simulation Curriculum for Intravenous Cannulation Training

Loukas

Nikiteas²,

Kanakis³

et al. 2010

Academic Emergency Medicine

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Objectives: Although virtual reality (VR) simulators play an important role in modern medical training, their efficacy is not often evaluated using learning curves. In this study, the learning curves of novice and intermediate users were elicited during a VR simulation-based curriculum for intravenous (IV) cannulation.Methods: This was a prospective observational study of subjects undergoing training using a VR model of IV cannulation. Participants were divided into two groups: novices (third-year medical students with no prior practical experience in IV catheterization) and intermediates (recent graduates with limited experience). Performance was measured with two endpoints: time to completion and errors committed. Errors were categorized as critical or noncritical. Learning curves (error score and time completion vs. session number) were analyzed using the Friedman's test. Performance before and after training was compared using the Kruskal-Wallis test. The Spearman rank correlation coefficient (r s ) was used to determine the correlation between time completion and error score estimates. The number of attempts required to complete the training phase was also measured and compared between the two groups.Results: Thirty subjects were enrolled: 17 in the novice group and 13 in the intermediate group. Learning curve plateaus of intermediates were reached in the sixth case scenario (session), whereas novices reached a plateau in the eighth session. Performance comparison of time to completion and errors showed significant improvement for both groups. Less time and fewer attempts were required by all trainees to complete a scenario while progressing through the curriculum. The overall number of IV cannulation attempts of novices was significantly higher than that of the intermediates throughout the course.Conclusions: Significant learning curves for novice and intermediate students were demonstrated after following the VR simulation-based curriculum. Competencies acquired during this educational course may provide an important advantage for training prior to actual clinical practice.

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Section: Discussionmentioning

confidence: 99%

A Virtual Reality Simulation Curriculum for Intravenous Cannulation Training

Loukas

Nikiteas²,

Kanakis³

et al. 2010

Academic Emergency Medicine

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“…All but one study demonstrated a positive association between higher fidelity and process skills (effect size = À0.63 to 0.70, five studies), and the single study with negative effect sizes had positive associations with both learner reactions and time skill outcomes. 25 Likewise, higher fidelity was associated with uniformly better time outcomes (effect size = 0.31 to 1.36, three studies). Only one study measured patient effects, 26 and although it reported moderate benefits to learning (effect size = 0.57), the comparison curriculum differed in more than just the level of fidelity.…”

Section: Comparison Between Alternate Types Of Technologyenhanced Simmentioning

confidence: 91%

“…There were 19 studies that used designs in which one approach to simulation-based education was compared with another (see Table 3). [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] Twelve of the 19 studies included prehospital providers as participants, and nine of these studies focused on airway management training. Because the research questions in these 19 studies varied substantially, we were unable to provide a quantitative synthesis of results.…”

Section: Comparison Between Alternate Types Of Technologyenhanced Simmentioning

confidence: 99%

“…Five of these compared "low-fidelity" to "high-fidelity" scenario-based teaching. [25][26][27][28][29] While none clearly described the features that defined fidelity as "low" or "high," it was implicit that high-fidelity simulation more closely resembled a living human patient or actual clinical setting. For example, Hoadley 27 compared knowledge and reaction outcomes between participants in an Advanced Cardiac Life Support course who were divided into two groups, one that was asked to gather all data from a mannequin and its monitoring devices, and another that was provided with all of this information by course instructors while using an inanimate mannequin.…”

Section: Comparison Between Alternate Types Of Technologyenhanced Simmentioning

confidence: 99%

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Technology‐enhanced Simulation in Emergency Medicine: A Systematic Review and Meta‐Analysis

Ilgen

Sherbino

Cook

2013

Academic Emergency Medicine

168

122

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Objectives: Technology-enhanced simulation is used frequently in emergency medicine (EM) training programs. Evidence for its effectiveness, however, remains unclear. The objective of this study was to evaluate the effectiveness of technology-enhanced simulation for training in EM and identify instructional design features associated with improved outcomes by conducting a systematic review. Methods:The authors systematically searched MEDLINE, EMBASE, CINAHL, ERIC, PsychINFO, Scopus, key journals, and previous review bibliographies through May 2011. Original research articles in any language were selected if they compared simulation to no intervention or another educational activity for the purposes of training EM health professionals (including student and practicing physicians, midlevel providers, nurses, and prehospital providers). Reviewers evaluated study quality and abstracted information on learners, instructional design (curricular integration, feedback, repetitive practice, mastery learning), and outcomes.Results: From a collection of 10,903 articles, 85 eligible studies enrolling 6,099 EM learners were identified. Of these, 56 studies compared simulation to no intervention, 12 compared simulation with another form of instruction, and 19 compared two forms of simulation. Effect sizes were pooled using a random-effects model. Heterogeneity among these studies was large (I 2 ! 50%). Among studies comparing simulation to no intervention, pooled effect sizes were large (range = 1.13 to 1.48) for knowledge, time, and skills and small to moderate for behaviors with patients (0.62) and patient effects (0.43; all p < 0.02 except patient effects p = 0.12). Among comparisons between simulation and other forms of instruction, the pooled effect sizes were small ( 0.33) for knowledge, time, and process skills (all p > 0.1). Qualitative comparisons of different simulation curricula are limited, although feedback, mastery learning, and higher fidelity were associated with improved learning outcomes.Conclusions: Technology-enhanced simulation for EM learners is associated with moderate or large favorable effects in comparison with no intervention and generally small and nonsignificant benefits in comparison with other instruction. Future research should investigate the features that lead to effective simulation-based instructional design.ACADEMIC EMERGENCY MEDICINE 2013; 20:117-127 © 2013 T echnology-enhanced simulation has emerged as a cornerstone of many emergency medicine (EM) training programs. 1-3 Simulation allows complex tasks to be deconstructed into more manageable learning objectives and fosters repeated practice on specific tasks that occur infrequently or expose patients to risk when performed by novice learners. 4 Computer-based virtual reality simulators, robotic and static mannequins, artificial models, live animals, inert animal products, and human cadavers have all been employed as educational tools for these purposes.1 At the 2008 Academic Emergency Medicine (AEM) consensus conference entitled...

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“…Lasome, Flaherty, & Torrance, 2002;Ahlberg, Hultcrantz, Jaramillo, Lindblom, & Arvidsson, 2005; D Alverson et al, 2005;Caudell et al, 2003;. Colt, Crawford, & Galbraith, 2001;Goolsby, Simulation and Short Course Programs…”

mentioning

confidence: 99%

Lessons Learned From an Evaluation of Serious Gaming as an Alternative to Mannequin-Based Simulation Technology: Randomized Controlled Trial

Benda¹,

Kellogg²,

Fairbanks³

et al. 2020

JMIR Serious Games

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Background The use of new technology like virtual reality, e-learning, and serious gaming can offer novel, more accessible options that have been demonstrated to improve learning outcomes. Objective The aim of this study was to compare the educational effectiveness of serious game–based simulation training to traditional mannequin-based simulation training and to determine the perceptions of physicians and nurses. We used an obstetric use case, namely electronic fetal monitoring interpretation and decision making, for our assessment. Methods This study utilized a mixed methods approach to evaluate the effectiveness of the new, serious game–based training method and assess participants’ perceptions of the training. Participants were randomized to traditional simulation training in a center with mannequins or serious game training. They then participated in an obstetrical in-situ simulation scenario to assess their learning. Participants also completed a posttraining perceptions questionnaire. Results The primary outcome measure for this study was the participants’ performance in an in-situ mannequin-based simulation scenario, which occurred posttraining following a washout period. No significant statistical differences were detected between the mannequin-based and serious game–based groups in overall performance, although the study was not sufficiently powered to conclude noninferiority. The survey questions were tested for significant differences in participant perceptions of the educational method, but none were found. Qualitative participant feedback revealed important areas for improvement, with a focus on game realism. Conclusions The serious game training tool developed has potential utility in providing education to those without access to large simulation centers; however, further validation is needed to demonstrate if this tool is as effective as mannequin-based simulation.

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Evaluation of a Virtual Reality Simulator in Sustainment Training

Cited by 12 publications

References 0 publications

A Virtual Reality Simulation Curriculum for Intravenous Cannulation Training

A Virtual Reality Simulation Curriculum for Intravenous Cannulation Training

Technology‐enhanced Simulation in Emergency Medicine: A Systematic Review and Meta‐Analysis

Lessons Learned From an Evaluation of Serious Gaming as an Alternative to Mannequin-Based Simulation Technology: Randomized Controlled Trial

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