Virtual Reality Instructional Design in Orthopedic Physical Therapy Education: A Randomized Controlled Trial

Abstract

Introduction. Effective clinical decisionmaking (CDM) skills are essential for physical therapist practice. e purpose of this study was to compare the effects of virtual reality (VR) patient simulation with those of a traditional standardized patient simulation on the CDM of student physical therapists (SPTs). Review of Literature. Authentic experiential learning opportunities are needed to promote CDM. e effects of VR simulation on the CDM of SPTs are unknown. Subjects. Fifty-nine first-year SPTs participated in this study.Methods. A randomized controlled trial compared the effects of VR with those of standardized patient simulation on several aspects of CDM in 59 first-year students after an upper extremity orthopedic unit. Perceived CDM abilities and metacognitive awareness were assessed before and after allocated instruction. Diagnostic accuracy and diagnostic efficiency were measured during instruction. Student engagement was assessed immediately after instruction and psychomotor skill was assessed 1 week later. Results. Statistically significant withingroup differences in CDM were noted after both VR and standardized patient instruction, but no between-group differences were found. Although effect sizes were considered large with either learning experience, the observed experimental effect was greater after a VR experience. No between-group differences were found between metacognitive awareness, diagnostic accuracy, or psychomotor skill assessment. Diagnostic efficiency was statistically significantly greater in the standardized patient condition, while engagement was significantly greater in the VR condition. Discussion and Conclusion. Measures of perceived CDM improved regardless of instructional method; however, the effect size was greater after VR. ese findings reveal 2 effective experiential learning options to promote CDM. ese results exemplify the normative trajectory of CDM development and recommendations for differentiated curricular instruction. Although resource intensive initially, VR technology appears capable of advancing CDM skills in an efficient manner that may minimize future cost and the faculty facilitation associated with standardized patient instruction.

Virtual and Augmented Reality versus Traditional Methods for Teaching Physiotherapy: A Systematic Review

“…In terms of study type, all studies compared VR/AR teaching with traditional teaching models, and five studies [ 25 , 33 , 34 , 35 , 38 ] used randomisation of the participants into different groups. Favolise [ 36 ] carried out a cohort longitudinal study, and Kandasamy et al [ 37 ] performed a crossover longitudinal study.…”

“…Thus, the total number of subjects included in the different studies was 737, 105 being the average number of subjects participating across the studies. Graduate students were involved in five studies [ 33 , 34 , 35 , 36 , 38 ], and undergraduate students took part in two studies [ 25 , 37 ].…”

“…The VR/AR-based teaching approaches were carried out using immersive VR systems wearing head-mounted displays [ 25 , 34 , 38 ], AR applications with anatomical projections [ 35 , 36 , 37 ], and a virtual patient simulator based on computer software [ 33 ].…”

“…Second, two studies [ 33 , 38 ] included content related to clinical decision-making skills. Hartstein et al [ 38 ] used an immersive VR learning experience with the Oculus Quest 2, and they did not find significant results when compared with traditional teaching.…”

“…Second, two studies [ 33 , 38 ] included content related to clinical decision-making skills. Hartstein et al [ 38 ] used an immersive VR learning experience with the Oculus Quest 2, and they did not find significant results when compared with traditional teaching. The study by Huhn et al [ 33 ] used a virtual patient simulation based on computer software and they found no statistical differences in academic performance and students’ perception of the learning experience.…”