Collaborative virtual reality based advanced cardiac life support training simulator using virtual reality principles
Collaborative virtual reality based advanced cardiac life support training simulator using virtual reality principles
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DOI：
10.1016/j.jbi.2014.04.005
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发表时间：
2014-10-01
影响因子：
4.5
通讯作者：
Smith, Marshall
中科院分区：
文献类型：
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作者：
Khanal, Prabal;Vankipuram, Akshay;Smith, Marshall
背景：高级心脏生命支持 (ACLS) 是一系列基于团队的、连续的、时间有限的干预措施，需要护理人员团队对发生心脏骤停或呼吸衰竭的患者进行的活动进行有效的沟通和协调。最先进的 ACLS 培训是在专家监督下的面对面环境中进行的，存在一些缺点，包括护理人员日程安排冲突和培训设备成本高昂。目的：本研究的主要目的是描述一种使用拟议的虚拟现实模拟器向护理人员提供 ACLS 培训的新方法，包括设计、实施和评估，该方法可以克服传统面对面培训方法带来的挑战和缺点。方法：我们比较与传统面对面培训方法相关的功效和绩效结果采用所提出的基于虚拟现实 (VR) 的 ACLS 训练模拟器的新方法进行 ACLS 训练。一百四十八 (148) 名获得 ACLS 认证的临床医生（即 26 个护理提供者团队）参加了这项研究。每个团队被随机分配到三个治疗组之一：控制组（传统 ACLS 训练）、说服组（具有全面反馈组件的 VR ACLS 训练）或最低限度说服组（具有有限反馈组件的 VR ACLS 训练）。这些团队在两种不同的 ACLS 程序中进行了测试，这两种程序的任务复杂程度有所不同：心室颤动或心动过速 (VFib/VTach) 和无脉电活动 (PEA)。结果：对照组和说服组之间的表现差异不具有统计学意义（PEA 的 P = 0.37，VFib/VTach 的 P = 0.1）。然而，对照组和最低说服力组之间的表现差异显着（PEA 的 P = 0.05，VFib/VTach 的 P = 0.02）。各组表现的前后比较显示，控制组（PEA P=.017，VFib/VTach P=.01）和说服组（PEA P=.02，VFib/VTach P=.048）显着改善了表现，而最低说服力组则没有显着改善（PEA P=.45，VFib/VTach P=.46）。结果还表明，说服力的好处受到这些功能的潜在干扰性的限制。 结论：我们的结果表明，具有适当反馈组件的基于 VR 的 ACLS 培训可以提供类似于面对面培训的学习体验，因此可以作为传统 ACLS 培训更容易访问的补充培训工具。我们的研究结果还表明，VR 环境中说服性功能的程度必须考虑反馈元素的中断性质。 (C) 2014 Elsevier Inc. 保留所有权利。
Background: Advanced Cardiac Life Support (ACLS) is a series of team-based, sequential and time constrained interventions, requiring effective communication and coordination of activities that are performed by the care provider team on a patient undergoing cardiac arrest or respiratory failure. The state-of-the-art ACLS training is conducted in a face-to-face environment under expert supervision and suffers from several drawbacks including conflicting care provider schedules and high cost of training equipment.Objective: The major objective of the study is to describe, including the design, implementation, and evaluation of a novel approach of delivering ACLS training to care providers using the proposed virtual reality simulator that can overcome the challenges and drawbacks imposed by the traditional face-to-face training method.Methods: We compare the efficacy and performance outcomes associated with traditional ACLS training with the proposed novel approach of using a virtual reality (VR) based ACLS training simulator. One hundred and forty-eight (148) ACLS certified clinicians, translating into 26 care provider teams, were enrolled for this study. Each team was randomly assigned to one of the three treatment groups: control (traditional ACLS training), persuasive (VR ACLS training with comprehensive feedback components), or minimally persuasive (VR ACLS training with limited feedback components). The teams were tested across two different ACLS procedures that vary in the degree of task complexity: ventricular fibrillation or tachycardia (VFib/VTach) and pulseless electric activity (PEA).Results: The difference in performance between control and persuasive groups was not statistically significant (P = .37 for PEA and P = .1 for VFib/VTach). However, the difference in performance between control and minimally persuasive groups was significant (P = .05 for PEA and P = .02 for VFib/VTach). The pre-post comparison of performances of the groups showed that control (P=.017 for PEA, P=.01 for VFib/VTach) and persuasive (P = .02 for PEA, P = .048 for VFib/VTach) groups improved their performances significantly, whereas minimally persuasive group did not (P = .45 for PEA, P = .46 for VFib/VTach). Results also suggest that the benefit of persuasiveness is constrained by the potentially interruptive nature of these features.Conclusions: Our results indicate that the VR-based ACLS training with proper feedback components can provide a learning experience similar to face-to-face training, and therefore could serve as a more easily accessed supplementary training tool to the traditional ACLS training. Our findings also suggest that the degree of persuasive features in VR environments have to be designed considering the interruptive nature of the feedback elements. (C) 2014 Elsevier Inc. All rights reserved.