Sok Ying Liaw1, Wei Ling Chua2, Jian Zhi Tan2, Tracy Levett-Jones3, Balakrishnan Ashokka4, Terry Ling Te Pan4, Siew Tiang Lau2, Jeanette Ignacio2. 1. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11 10 Medical Drive, Singapore, 117597, Singapore. nurliaw@nus.edu.sg. 2. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11 10 Medical Drive, Singapore, 117597, Singapore. 3. School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, Australia. 4. Department of Anaesthesia, Yong Loo Lin School Medicine, National University of Singapore, Singapore, Singapore.
Abstract
BACKGROUND: Simulation-based education can equip healthcare providers with the ability to respond to and manage stressors associated with rapidly deteriorating patient situations. However, little is known about the benefits of using virtual reality (VR) for this purpose. OBJECTIVE: To compare between desktop VR and face-to-face simulation in stress responses and performance outcomes of a team-based simulation training in managing clinical deterioration. DESIGN: A randomised controlled study METHOD: The study was conducted on 120 medical and nursing students working in interprofessional teams. The teams were randomly assigned to participate in a 2-h simulation using either the desktop VR or face-to-face simulation with simulated patient (SP). Biophysiological stress response, psychological stress, and confidence levels were measured before and after the simulation. Performance outcomes were evaluated after the simulation using a deteriorating patient scenario. RESULTS: The systolic blood pressure and psychological stress response were significantly increased among participants in VR and SP groups; however, no significant differences were found between the groups. There was also no significant difference in confidence and performance outcomes between participants in the VR and SP groups for both medical and nursing students. Although the psychological stress response was negatively correlated (r = -0.43; p < 0.01) with confidence levels, there was no association between stress response and performance score. CONCLUSION: Despite being less immersive, the desktop VR was capable of inducing psychological and physiological stress responses by placing emotional, social, and cognitive demands on learners. Additionally, by ensuring close alignment between the simulation tasks and the clinical tasks (i.e. functional fidelity), the desktop VR may provide similar performance outcomes as conventional simulation training. This evidence is timely given the rise in the use of virtual learning platforms to facilitate training during the COVID-19 pandemic where face-to-face training may not be feasible. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov NCT04330924.
BACKGROUND: Simulation-based education can equip healthcare providers with the ability to respond to and manage stressors associated with rapidly deteriorating patient situations. However, little is known about the benefits of using virtual reality (VR) for this purpose. OBJECTIVE: To compare between desktop VR and face-to-face simulation in stress responses and performance outcomes of a team-based simulation training in managing clinical deterioration. DESIGN: A randomised controlled study METHOD: The study was conducted on 120 medical and nursing students working in interprofessional teams. The teams were randomly assigned to participate in a 2-h simulation using either the desktop VR or face-to-face simulation with simulated patient (SP). Biophysiological stress response, psychological stress, and confidence levels were measured before and after the simulation. Performance outcomes were evaluated after the simulation using a deteriorating patient scenario. RESULTS: The systolic blood pressure and psychological stress response were significantly increased among participants in VR and SP groups; however, no significant differences were found between the groups. There was also no significant difference in confidence and performance outcomes between participants in the VR and SP groups for both medical and nursing students. Although the psychological stress response was negatively correlated (r = -0.43; p < 0.01) with confidence levels, there was no association between stress response and performance score. CONCLUSION: Despite being less immersive, the desktop VR was capable of inducing psychological and physiological stress responses by placing emotional, social, and cognitive demands on learners. Additionally, by ensuring close alignment between the simulation tasks and the clinical tasks (i.e. functional fidelity), the desktop VR may provide similar performance outcomes as conventional simulation training. This evidence is timely given the rise in the use of virtual learning platforms to facilitate training during the COVID-19 pandemic where face-to-face training may not be feasible. TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov NCT04330924.
Authors: Sok Ying Liaw; Lai Fun Wong; Sophia Bee Leng Ang; Jasmine Tze Yin Ho; Chiang Siau; Emily Neo Kim Ang Journal: BMJ Qual Saf Date: 2015-08-21 Impact factor: 7.035
Authors: Sok Ying Liaw; Shawn Leng-Hsien Soh; Khoon Kiat Tan; Ling Ting Wu; John Yap; Yeow Leng Chow; Tang Ching Lau; Wee Shiong Lim; Seng Chee Tan; Hyekyung Choo; Li Lian Wong; Sok Mui Lim; Jeanette Ignacio; Lai Fun Wong Journal: Nurse Educ Today Date: 2019-07-02 Impact factor: 3.442
Authors: Sok Ying Liaw; Sim Win Ooi; Khairul Dzakirin Bin Rusli; Tang Ching Lau; Wilson Wai San Tam; Wei Ling Chua Journal: J Med Internet Res Date: 2020-04-08 Impact factor: 5.428