The use of virtual reality and other technology mediated simulations is in early stages. Guidelines and protocols are still being developed. However, much of what we have used in other forms of ...simulation can be successfully adapted and implemented. This article will highlight selected areas for use of virtual reality in nursing education. Current literature describes the evidence in this area that includes immersive and desktop virtual realities. Both modalities provide an experiential learning platform that has demonstrated gains in knowledge acquisition and effective learning outcomes. There are several options available to use virtual reality in nursing education. Appropriate educational frameworks and alignment of the virtual reality experience with learning outcomes are important considerations. Infrastructure and support for immersive or desktop virtual reality will look different. It is beneficial to collaborate with instructional technology support staff early in the process as options are explored. Overall, technology mediated simulations using virtual reality is a promising new area for nurse educators. A thoughtful, informed approach can facilitate positive learner experiences and strong outcomes.
Purpose
To investigate the correlation in performance of cataract surgery between a virtual‐reality simulator and real‐life surgery using two objective assessment tools with evidence of validity.
...Methods
Cataract surgeons with varying levels of experience were included in the study. All participants performed and videorecorded three standard cataract surgeries before completing a proficiency‐based test on the EyeSi virtual‐reality simulator. Standard cataract surgeries were defined as: (1) surgery performed under local anaesthesia, (2) patient age >60 years, and (3) visual acuity >1/60 preoperatively. A motion‐tracking score was calculated by multiplying average path length and average number of movements from the three real‐life surgical videos of full procedures. The EyeSi test consisted of five and two procedural modules: intracapsular navigation, antitremor training, intracapsular antitremor training, forceps training, bimanual training, capsulorhexis and phaco divide and conquer.
Results
Eleven surgeons were enrolled. After a designated warm‐up period, the proficiency‐based test on the EyeSi simulator was strongly correlated to real‐life performance measured by motion‐tracking software of cataract surgical videos with a Pearson correlation coefficient of −0.70 (p = 0.017).
Conclusion
Performance on the EyeSi simulator is significantly and highly correlated to real‐life surgical performance. However, it is recommended that performance assessments are made using multiple data sources.
This systematic review, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, is aimed to review current research in virtual reality (VR) for ...healthcare training, specifically pertaining to nontechnical skills. PsycInfo and Medline databases were queried for relevant articles published through December 2017. Of the 1377 publications identified, 80 were assessed for eligibility and 26 were finally included in the qualitative synthesis. Overall, the use of virtual training for nontechnical skills is recent in healthcare education and has increased since 2010. Screen-based VR simulators or virtual worlds are the most frequently used systems. The nontechnical skills addressed in VR simulation include mainly teamwork, communication, and situation awareness. Most studies evaluate the usability and acceptability of VR simulation, and few studies have measured the effects of VR simulation on nontechnical skills development.
Abstract Introduction Laparoscopic surgery requires a different and sometimes more complex skill set than does open surgery. Shortened working hours, less training times, and patient safety issues ...necessitates that these skills need to be acquired outside the operating room. Virtual reality simulation in laparoscopic surgery is a growing field, and many studies have been published to determine its effectiveness. Aims This systematic review and meta-analysis aims to evaluate virtual reality simulation in laparoscopic abdominal surgery in comparison to other simulation models and to no training. Methods A systematic literature search was carried out until January 2014 in full adherence to PRISMA guidelines. All randomised controlled studies comparing virtual reality training to other models of training or to no training were included. Only studies utilizing objective and validated assessment tools were included. Results Thirty one randomised controlled trials that compare virtual reality training to other models of training or to no training were included. The results of the meta-analysis showed that virtual reality simulation is significantly more effective than video trainers, and at least as good as box trainers. Conclusion The use of Proficiency-based VR training, under supervision with prompt instructions and feedback, and the use of haptic feedback, has proven to be the most effective way of delivering the virtual reality training. The incorporation of virtual reality training into surgical training curricula is now necessary. A unified platform of training needs to be established. Further studies to assess the impact on patient outcomes and on hospital costs are necessary. (PROSPERO Registration number: CRD42014010030)
Virtual Patient Simulations (VPSs) have been cited as a novel learning strategy, but there is little evidence that VPSs yield improvements in clinical reasoning skills and medical knowledge. This ...study aimed to clarify the effectiveness of VPSs for improving clinical reasoning skills among medical students, and to compare improvements in knowledge or clinical reasoning skills relevant to specific clinical scenarios. We enrolled 210 fourth-year medical students in March 2017 and March 2018 to participate in a real-time pre-post experimental design conducted in a large lecture hall by using a clicker. A VPS program (®Body Interact, Portugal) was implemented for one two-hour class session using the same methodology during both years. A pre–post 20-item multiple-choice questionnaire (10 knowledge and 10 clinical reasoning items) was used to evaluate learning outcomes. A total of 169 students completed the program. Participants showed significant increases in average total post-test scores, both on knowledge items (pre-test: median = 5, mean = 4.78, 95% CI (4.55–5.01); post-test: median = 5, mean = 5.12, 95% CI (4.90–5.43); p-value = 0.003) and clinical reasoning items (pre-test: median = 5, mean = 5.3 95%, CI (4.98–5.58); post-test: median = 8, mean = 7.81, 95% CI (7.57–8.05); p-value < 0.001). Thus, VPS programs could help medical students improve their clinical decision-making skills without lecturer supervision.
The use of catheter-based skills is increasing in the field of vascular trauma. Virtual reality simulation (VRS) is a well-established means of endovascular skills training, and potentially ...lifesaving skills such as resuscitative endovascular balloon occlusion of the aorta (REBOA) may be obtained through VRS.
Thirteen faculty members in the Division of Trauma and Critical Care performed REBOA six times on the Vascular Intervention System Training Simulator-C after a didactic and instructional session. Subjects were excluded if they had taken a similar endovascular training course, had additional training in endovascular surgery, or had performed this procedure in the clinical setting. Performance metrics included procedural time; accurate placement of guide wire, sheath, and balloon; correct sequence of steps; economy of motion; and safe use of endovascular tools. A precourse and postcourse test and questionnaire were performed by each subject.
Significant improvements in knowledge (p = 0.0013) and procedural task times (p < 0.0001) were observed at the completion of the course. No correlation was observed with endovascular experience in residency, number of central and arterial catheters placed weekly, or other parameters. All trainees strongly agreed that the course was beneficial, and the majority would recommend this training to other acute care surgeons.
Damage control endovascular procedures can be effectively taught using VRS. Significant improvements in procedural time and knowledge can be achieved regardless of endovascular experience in residency, years since residency, or other parameters. Novice interventionalists (acute care surgeons) can add a specific skill set (REBOA) to their existing core competencies, which has the potential to improve the survival and/or outcomes of severely injured patients.
Training young physicians in gastrointestinal endoscopy through virtual reality (VR) simulators has become popular. It is important to evaluate the benefits and usefulness of this technology for ...teaching endoscopic skills. The objective of this literature review is to understand the benefits of VR technology through quantitative and qualitative examination of learning outcomes.
A literature search of 7 databases was conducted. Studies which compared the effects of learning through VR simulation and another method of learning were included. In addition, studies were included if they evaluated learning outcomes on clinical patients. Participants could be medical residents, fellows, physicians, or nurses. Common outcomes measured across studies included subjective overall performance scores, total procedure times, rate of successful procedure completion, error rates, patient pain or discomfort, and measures of independence.
A total of 22 studies were included. Overall, VR simulation training was seen to be comparable or significantly better than clinical training, no training, other types of simulation, and another form of VR training. Many authors reported increasing patient safety, reducing stress and time constraints, and shortening the learning curve as advantages of VR simulation training. However, this form of training is also expensive and may result in the learning of bad habits.
VR simulation technology can be a valuable form of educating endoscopy novices if properly supervised during training, and if there is also integration of clinical training.
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