Technology-enhanced simulation for healthcare professionals: A meta-analysis

Abstract

AimThere have been substantial changes in the simulation technology landscape, in particular virtual reality (VR), during the past decade, which have resulted in increased abundance and decreased cost. We therefore updated a previous meta-analysis conducted in 2011, aiming to quantify the impact of digital technology-enhanced simulation (T-ES) compared with traditional teaching in physicians, physicians-in-training, nurses, and nursing students.DesignWe conducted a meta-analysis consisting of randomized controlled trials published in English between January 2011 and December 2021 in peer-reviewed journals indexed in seven databases. Moderators for study duration, instruction, type of healthcare worker, type of simulation, outcome measure, and study quality rated by Medical Education Research Study Quality Instrument (MERSQI) score were included in our model and used to calculate estimated marginal means (EMMs).ResultsThe overall effect of T-ES was positive across the 59 studies included in the analysis compared with traditional teaching [overall effect size 0.80 (95% CI 0.60, 1.00)]. This indicates that T-ES is effective in improving outcomes across a wide variety of settings and participants. The impact of T-ES was found to be greatest for expert-rated product metrics such as procedural success, and process metrics such as efficiency, compared with knowledge and procedure time metrics.ConclusionsThe impacts of T-ES training on the outcome measures included in our study were greatest in nurses, nursing students and resident physicians. T-ES was strongest in studies featuring physical high-fidelity mannequins or centers, compared with VR sensory environment T-ES, though there was considerable uncertainty in all statistical analyses. Further high-quality studies are required to assess direct effects of simulation training on patient and public health outcomes.

Robots as behavior change agents: Can robots teach behavior technicians to implement differential reinforcement?

“…These robots can substitute up to 50% of prelicensure nurses' traditional training hours, they hasten the acquisition of clinical skills, reduce risks to patients, and provide the opportunity to train for rare or uncommon events (Fritz et al, 2008). In addition, robots effectively enhance the confidence of medical students beginning clinical practice, reduce student anxiety, and encourage the development of professional identities in nurses (Mitchell & Ivimey-Cook, 2023). However, robots have not been adopted on a wider scale because of some of the limitations related to programming and maintenance (Fritz et al, 2008), making VR a suitable alternative for certain applications.…”

“…It is important to note, however, that if VR is to be used with advanced physical sensors and capabilities, integration of body wear is needed, and the current additional cost of such hardware is about $12,999 for bodywear and $14,999 for gloves (see, for example, https://teslasuit.io/). Although VR may have advantages in some applications and robots in others, a combination of both VR and robots produced greater outcomes than VR alone in training medical workers (Iqbal et al, 2021; Mitchell & Ivimey-Cook, 2023). In our view, the operandum is only a means to an end; what is of practical value is whether the targeted skills generalize to clinical practice and whether the operandum is accessible for widespread use.…”

“…In medicine, humanoid robots, referred to as high-fidelity mannequin simulators, have been used to simulate patients and train medical staff in various skills successfully (see Mitchell & Ivimey-Cook, 2023 for a meta-analysis). Behavior analysts have also started demonstrating the effectiveness of humanoid robots in training behavior change skills to clinicians.…”

Virtual Reality and Simulation Videos as Effective Training Tools for Creating Safe and Inclusive Environments for Transgender People

“…The use of ICTs is increasing exponentially in health sciences due to the extensive use of mobile devices [ 16 ]. Compared to traditional education methods, the use of ICTs makes a greater contribution to improving students’ self-confidence, increasing their level of knowledge, and enhancing skills acquisition [ 17 , 18 , 19 ].…”

“…The popularity of VR stems from its positive impact on learning outcomes and development of critical thinking, decision making, and clinical reasoning and judgement [ 12 ]. Moreover, under these conditions, students can experiment and learn to master new skills in simulated environments that are very similar to real life without endangering themselves or users [ 18 , 19 ]. Therefore, VR can help learners develop communication skills [ 11 ] and non-technical skills, such as awareness and understanding, which are essential for empathy [ 24 ], as well as stress management, leadership, and teamwork [ 12 ].…”