A virtual patient model for students' interprofessional learning in primary healthcare

Theoretical foundations and implications of augmented reality, virtual reality, and mixed reality for immersive learning in health professions education

BACKGROUND

Augmented Reality (AR), Virtual Reality (VR) and Mixed Reality (MR) are emerging technologies that can create immersive learning environments for health professions education. However, there is a lack of systematic reviews on how these technologies are used, what benefits they offer, and what instructional design models or theories guide their use.

AIM

This scoping review aims to provide a global overview of the usage and potential benefits of AR/VR/MR tools for education and training of students and professionals in the healthcare domain, and to investigate whether any instructional design models or theories have been applied when using these tools.

METHODOLOGY

A systematic search was conducted in several electronic databases to identify peer-reviewed studies published between and including 2015 and 2020 that reported on the use of AR/VR/MR in health professions education. The selected studies were coded and analyzed according to various criteria, such as domains of healthcare, types of participants, types of study design and methodologies, rationales behind the use of AR/VR/MR, types of learning and behavioral outcomes, and findings of the studies. The (Morrison et al. John Wiley & Sons, 2010) model was used as a reference to map the instructional design aspects of the studies.

RESULTS

A total of 184 studies were included in the review. The majority of studies focused on the use of VR, followed by AR and MR. The predominant domains of healthcare using these technologies were surgery and anatomy, and the most common types of participants were medical and nursing students. The most frequent types of study design and methodologies were usability studies and randomized controlled trials. The most typical rationales behind the use of AR/VR/MR were to overcome limitations of traditional methods, to provide immersive and realistic training, and to improve students' motivations and engagements. The most standard types of learning and behavioral outcomes were cognitive and psychomotor skills. The majority of studies reported positive or partially positive effects of AR/VR/MR on learning outcomes. Only a few studies explicitly mentioned the use of instructional design models or theories to guide the design and implementation of AR/VR/MR interventions.

DISCUSSION AND CONCLUSION

The review revealed that AR/VR/MR are promising tools for enhancing health professions education, especially for training surgical and anatomical skills. However, there is a need for more rigorous and theory-based research to investigate the optimal design and integration of these technologies in the curriculum, and to explore their impact on other domains of healthcare and other types of learning outcomes, such as affective and collaborative skills. The review also suggested that the (Morrison et al. John Wiley & Sons, 2010) model can be a useful framework to inform the instructional design of AR/VR/MR interventions, as it covers various elements and factors that need to be considered in the design process.

Student experiences in a novel interprofessional neurodevelopmental clinic: a qualitative study

BACKGROUND

Student-led clinics can provide low-cost speciality care and practical interprofessional education (IPE) opportunities. In Australia, there are currently limited speciality services available that provide neurodevelopmental assessments that consider fetal alcohol spectrum disorder (FASD) as one possible outcome. The aim of the current study was to understand student experiences in a novel interprofessional student-led clinic for children and adolescents with suspected or confirmed prenatal alcohol exposure.

METHOD

Seventeen allied health university students (11 occupational therapy; 6 psychology) participated in individual semi-structured interviews following completion of a 10-week clinic placement. Reflexive thematic analysis was undertaken using NVivo12.

RESULTS

Four main themes were generated: (1) Interprofessional practice a key for students' development as future healthcare professionals; (2) Meaningful relationships and students' belief they made a difference; (3) Novel challenges tested students' capabilities on placement; and (4) Supervisor attitude and approach to learning supported student development.

CONCLUSIONS

The current study demonstrated that the interprofessional student-led neurodevelopmental clinic provided a valuable IPE opportunity for students.

Effect of Virtual Reality Simulation Versus Traditional Education on Rates of Clostridium difficile Infection: An Experimental Cluster Randomized Controlled Trial and Return on Investment Analysis

BACKGROUND

Virtual reality simulation (VRS) is an innovative modality in nursing professional development that has the potential to affect patient outcomes.

METHOD

An experimental cluster randomized controlled trial was performed with RNs on two inpatient units at a large academic health system. The purpose of this study was to evaluate the effect of VRS compared with traditional education on Clostridium difficile rates. Return on investment of nursing professional development activities was also measured to support decision-making and resource allocation.

RESULTS

Rates of C. difficile infection were significantly lower for both groups for the 3-month postintervention period compared with the 10-month period preintervention. Financial analysis showed a return on investment for both modalities, with VRS having higher yields over time.

CONCLUSION

Findings showed that VRS was an effective instructional method. [J Contin Educ Nurs. 2024;55(7):351-358.].

The Effect of Video-Based Simulation Training on Nursing Students' Motivation and Academic Achievement: A Mixed Study

This study was conducted to determine the effect of video-based simulation education on nursing students' motivation and academic achievement. The research was designed in a mixed model. A quasi-experimental method with a pretest-posttest control group was used for the quantitative part, and the descriptive phenomenology approach was used as the qualitative research method. The sample of the study consisted of second-year nursing students in two state universities in eastern Turkey. The data were collected with the Student Information Form, the Academic Achievement Test, and the Motivation Resources and Problems Scale using Google Forms Web application. Qualitative data were collected through online semistructured interview forms and focus group interviews. According to the results, the posttest academic achievement and Motivation Resources and Problems Scale mean scores of the students in the intervention group were significantly higher than those of the control group ( P < .05). In the analysis of the qualitative, three main themes emerged: We felt fortunate that it increased information retention," "We felt like we were in real practice environment," and "It made us feel that we were nurses." The results showed the use of video-based simulation can be suggested as a strategy to promote classroom teaching and engage students.

Effect of a Virtual Reality Simulation Modality on Registered Nurse Knowledge and Behavior Related to Clostridioides difficile Prevention : An Experimental, Cluster Randomized Controlled Trial

Virtual reality simulation (VRS) has emerged as an educational methodology in nursing professional development. A cluster randomized controlled trial was conducted with a sample of clinical registered nurses to compare effectiveness of VRS and traditional education on knowledge and behavior related to Clostridioides difficile prevention. No significant differences were found in the effectiveness of the two modalities, suggesting the usefulness of VRS as a teaching methodology.

Learning and clinical reasoning experience of second-year medical pharmacology students and teachers with virtual patients developed using OpenLabyrinth

<b>Objective: </b>To determine the perceived usefulness of a virtual case scenario developed and delivered through the OpenLabyrinth platform among medical students and teachers.<br /> <b>Methods: </b>20 second-year medical students and 12 teachers of pharmacology were invited to complete a virtual case scenario exercise. The participants accessed the case scenario using their laptops or mobile devices. Participants’ feedback was obtained using the electronic virtual patient consortium-developed questionnaire.<br /> <b>Results: </b>19 students and 12 teachers provided feedback. All the faculty members and 95% of students felt that they had to make the same decisions a doctor would have to make in real life; ‘authenticity of patient encounter’ received the highest percentage of positive responses and ‘the learning effect’ the least.<br /> <b>Conclusions: </b>The feedback obtained suggests that virtual case scenarios are likely to be well received by students and teachers. The availability of open-source software enables the use of this technology in resource-limited settings.

Nursing Students' Scenario Performance: Game Metrics in a Simulation Game

AIM

The purpose of this study was to examine nursing students' scenario performance in a simulation game by utilizing game metrics.

BACKGROUND

A significant advantage of simulation games is that they can store large amounts of data. Although game metrics enable the objective evaluation and analysis of performance, their use in the evaluation of students' performance is limited.

METHOD

Nursing students (N = 376) played a simulation game at home for 1 week. The resulting data consisted of game metrics stored in the game: number of playthroughs, mean scores, and mean playing times.

RESULTS

The total number of playthroughs was 1,923. Statistically significant differences were found between different scenarios regarding the mean score (p < .0001). Mean playing time was significantly associated with the mean score (p < .05).

CONCLUSION

Game metrics demonstrate nursing students' scenario performance in clinical reasoning skills in different scenarios in a simulation game.

Medical Students' Learning About Other Professions Using an Interprofessional Virtual Patient While Remotely Connected With a Study Group: Mixed Methods Study

BACKGROUND

Collaboration with other professions is essential in health care education to prepare students for future clinical teamwork. However, health care education still struggles to incorporate interprofessional education. Distance learning and virtual patients (VPs) may be useful additional methods to increase students' possibilities for interprofessional learning.

OBJECTIVE

This study had two aims. The first was to assess if an interprofessional VP case could facilitate medical students' learning about team collaboration in online groups. The second was to assess how students experienced learning with the VP when remotely connected with their group.

METHODS

A mixed methods design was used. The VP case was a 73-year-old man who needed help from different health professions in his home after a hip fracture. Questionnaires were answered by the students before and directly after each session. Qualitative group interviews were performed with each group of students directly after the VP sessions, and the interviews were analyzed using qualitative content analysis.

RESULTS

A total of 49 third-year medical students divided into 15 groups participated in the study. Each group had 2 to 5 students who worked together with the interprofessional VP without a teacher's guidance. In the analysis of the group interviews, a single theme was identified: the interprofessional VP promoted student interaction and gave insight into team collaboration. Two categories were found: (1) the structure of the VP facilitated students' learning and (2) students perceived the collaboration in their remotely connected groups as functioning well and being effective. The results from the questionnaires showed that the students had gained insights into the roles and competencies of other health care professions.

CONCLUSIONS

This study demonstrates that an interprofessional VP enabled insights into team collaboration and increased understanding of other professions among student groups comprising only medical students. The interprofessional VP seemed to benefit students' learning in an online, remote-learning context. Although our VP was not used as an interprofessional student activity according to the common definition of interprofessional education, the results imply that it still contributed to students' interprofessional learning.

Computerized Simulation Education on Physiotherapy Students' Skills and Knowledge: A Systematic Review

INTRODUCTION

Applying computerized simulation education tool for learning in medical domains is widely used in many countries. This review is aimed at systematically investigating the computerized simulation tools developed to educate physiotherapy students and determine the effectiveness of these interventions.

METHODS

A comprehensive search was conducted in Medline (through PubMed) and Scopus databases from inception to Sept. 10, 2022. The studies that examined the effectiveness of computerized simulation-based interventions were included.

RESULTS

Sixteen studies were included in this systematic review. All included examinations were ranked "good" or "low risk of bias" based on the criteria utilized in the Joanna Briggs Institute (JBI) scale and the Effective Public Health Practice Project (EPHPP) tool. Most of the articles (43%) were conducted in the USA and 25% in Australia. In 43% of the total studies, the study population was only physiotherapy students, and in 12.5% of them, the scope of education was related to practical skills training. Three of the 16 reviewed articles presented positive qualitative results; thirteen quantitative investigations also declared statistically positive effects. Positive effects have been seen in areas such as improving professional and behavioral abilities, improving knowledge and self-confidence, and reducing stress. The sample size of the studies ranged from eight to 162 participants. The limited sample sizes in groups, lack of interaction, and short follow-up duration were the most consistent limitations evident within the included studies.

CONCLUSION

Computerized simulation education approaches can help to improve physiotherapy students' skills and knowledge. They also have great potential to reduce learning costs and increase the quality of education.

Virtual and Artificial Cardiorespiratory Patients in Medicine and Biomedical Engineering

Recently, ‘medicine in silico’ has been strongly encouraged due to ethical and legal limitations related to animal experiments and investigations conducted on patients. Computer models, particularly the very complex ones (virtual patients—VP), can be used in medical education and biomedical research as well as in clinical applications. Simpler patient-specific models may aid medical procedures. However, computer models are unfit for medical devices testing. Hybrid (i.e., numerical–physical) models do not have this disadvantage. In this review, the chosen approach to the cardiovascular system and/or respiratory system modeling was discussed with particular emphasis given to the hybrid cardiopulmonary simulator (the artificial patient), that was elaborated by the authors. The VP is useful in the education of forced spirometry, investigations of cardiopulmonary interactions (including gas exchange) and its influence on pulmonary resistance during artificial ventilation, and explanation of phenomena observed during thoracentesis. The artificial patient is useful, inter alia, in staff training and education, investigations of cardiorespiratory support and the testing of several medical devices, such as ventricular assist devices and a membrane-based artificial heart.