Exploring Virtual Worlds for Scenario-Based Repeated Team Training of Cardiopulmonary Resuscitation in Medical Students

Abstract

BackgroundContemporary learning technologies, such as massively multiplayer virtual worlds (MMVW), create new means for teaching and training. However, knowledge about the effectiveness of such training is incomplete, and there are no data regarding how students experience it. Cardiopulmonary resuscitation (CPR) is a field within medicine in high demand for new and effective training modalities.ObjectiveIn addition to finding a feasible way to implement CPR training, our aim was to investigate how a serious game setting in a virtual world using avatars would influence medical students’ subjective experiences as well as their retention of knowledge.MethodsAn MMVW was refined and used in a study to train 12 medical students in CPR in 3-person teams in a repeated fashion 6 months apart. An exit questionnaire solicited reflections over their experiences. As the subjects trained in 4 CPR scenarios, measurements of self-efficacy, concentration, and mental strain were made in addition to measuring knowledge. Engagement modes and coping strategies were also studied. Parametric and nonparametric statistical analyses were carried out according to distribution of the data.ResultsThe majority of the subjects reported that they had enjoyed the training, had found it to be suitable, and had learned something new, although several asked for more difficult and complex scenarios as well as a richer virtual environment. The mean values for knowledge dropped during the 6 months from 8.0/10 to 6.25/10 (P = .002). Self-efficacy increased from before to after each of the two training sessions, from 5.9/7 to 6.5/7 (P = .01) after the first and from 6.0/7 to 6.7/7 (P = .03) after the second. The mean perceived concentration value increased from 54.2/100 to 66.6/100 (P = .006), and in general the mental strain was found to be low to moderate (mean = 2.6/10).ConclusionsUsing scenario-based virtual world team training with avatars to train medical students in multi-person CPR was feasible and showed promising results. Although we found no evidence of stimulated recall of CPR procedures in our test-retest study, the subjects were enthusiastic and reported increased concentration during the training. We also found that subjects’ self-efficacy had increased after the training. Despite the need for further studies, these findings imply several possible uses of MMVW technology for future emergency medical training.

Major Incident Preparation for Acute Hospitals: Current State-of-the-Art, Training Needs Analysis, and the Role of Novel Virtual Worlds Simulation Technologies

“…The feasibility of VWs to train and evaluate health professionals and students has been investigated in cardiopulmonary resuscitation training, operating theater induction, decision-making skills, diabetes management, and teamwork in emergency situations (27)(28)(29)(30)(31). Moreover, the Virtual Association of Surgeons has successfully held a conference in the VW attended by numerous members from five countries (32).…”

Evaluation of Nurses’ Perceptions on Cardiopulmonary Resuscitation (CPR) Education

“…In 2010, a study investigated the effectiveness of multiplayer virtual worlds using avatars in CPR training of medical students. The research showed promising results about resuscitation training efficacy but also the satisfaction of the participants was quite high [29]. In 2012, groups of pre-clinical medical students were pre-trained on CPR performance using serious game technology.…”

O Uso de Simuladores no Ensino da Medicina

“…Cardiopulmonary resuscitation [26,27] Massively multiplayer virtual world A test-retest (6-month interval between sessions) Educacionais Online virtual patients [28] The Clinical Health Economics System Simulation (CHESS) [29] Computerized team-based quasi-competitive simulator Tabela 1: Exemplos de simuladores para a área da saúde.…”