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Rehl D, Mangapora M, Love M, Love C, Shaw K, McCarthy J, Beverly EA. Feasibility of a cinematic-virtual reality training program about opioid use disorder for osteopathic medical students: a single-arm pre-post study. J Osteopath Med 2024; 0:jom-2023-0188. [PMID: 38965036 DOI: 10.1515/jom-2023-0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 05/16/2024] [Indexed: 07/06/2024]
Abstract
CONTEXT Opioid use disorder (OUD) has a considerable morbidity and mortality in the United States. Healthcare providers are key points of contact for those with OUD; however, some providers may hold stigma toward OUD. Stigma toward OUD can lead to lower quality of care and more negative health outcomes. Thus, new trainings designed to reduce stigma toward OUD while increasing empathy are critical. We created a web-based cinematic virtual reality (cine-VR) training program on OUD for osteopathic medical students. OBJECTIVES The aim of this pilot study was to assess changes in stigma toward OUD and empathy before and after the online cine-VR training program on OUD. METHODS We employed a single-arm, pre- and posttest pilot study to assess changes in stigma toward OUD and empathy. Osteopathic medical students from one large medical school in the Midwest with three campuses were invited to participate in the online cine-VR training. Participants completed two surveys before and after the cine-VR training. We performed paired t tests to examine changes in stigma toward OUD and empathy scores before and after the cine-VR OUD training program. RESULTS A total of 48 participants completed the training. We observed a decrease in stigma toward OUD posttraining (t=4.402, p<0.001); this change had a Cohen's d of 0.64, indicating a medium effect. We also observed an increase in participants' empathy scores posttraining (t=-2.376, p=0.023), with a Cohen's d of 0.40 signifying a small effect. CONCLUSIONS Findings from this pilot study suggest that the online cine-VR training may reduce stigma toward OUD while increasing empathy. Future research employing a randomized controlled trial design with a larger, more diverse sample and a proper attention control condition is needed to confirm the effectiveness of the online cine-VR training. If confirmed, this cine-VR training may be an accessible approach to educating osteopathic medical students about OUD.
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Affiliation(s)
- Dominique Rehl
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Mason Mangapora
- Department of Medicine, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Matthew Love
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
| | - Carrie Love
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
| | - Kerri Shaw
- Ohio Alliance for Population Health, Ohio University, Athens, OH, USA
| | - John McCarthy
- College of Health Sciences Professions, Ohio University, Athens, OH, USA
| | - Elizabeth A Beverly
- Department of Primary Care, 105810 Ohio University Heritage College of Osteopathic Medicine, The Ohio University Diabetes Institute , Athens, OH, USA
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Kai K, Shinoda H, Takeiri E, Hamada T, Chikubu M, Kodama Y, Higuchi K, Nanashima A. Acceptance of Virtual Reality Simulation Training for Stoma Care by Healthcare Providers: A Pilot Questionnaire Study After Viewing Prototype Imagings. Cureus 2024; 16:e65465. [PMID: 39184595 PMCID: PMC11345116 DOI: 10.7759/cureus.65465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2024] [Indexed: 08/27/2024] Open
Abstract
OBJECTIVES Educational simulation systems using virtual reality (VR) with head-mounted devices are spreading into the medical field. We developed an innovative training system whereby experienced ostomates can share their proficient stoma self-care techniques with novice ostomates through VR simulations, enabling anytime, anywhere learning. We examined the questionnaire study to assess the acceptance of VR simulation training for stoma care by healthcare providers. METHODS This study was conducted for the participants, nurses, and doctors, at the 39th Kyushu Stoma Rehabilitation Research Meeting with the organizer's permission. We created two VR simulation prototypes from the perspective of ostomates and caregivers using modeled stomas. We conducted a qualitative study through a questionnaire with healthcare professionals regarding their experiences of viewing VR videos. RESULTS The study included 20 (52.6%) nurses certified in wound, ostomy, and continence (WOC) care, 16 (42.1%) non-WOC nurses, and two (5.3%) medical doctors. Over 90% of participants showed a positive inclination towards the practical application of the system in clinical settings for both scenarios. A significantly higher number of nurses in the non-WOC nurse group expressed a definite interest in using the imaging from the ostomate's perspective versus that in the WOC nurse group (81.3% vs. 40%, P=0.013). CONCLUSIONS From this survey, we concluded that the respondents felt a VR training system was a positive experience, to say it is acceptable means that it was as good as the standard of care. Particularly, non-WOC nurses, with fewer opportunities in stoma care compared to WOC nurses, showed stronger interest in practically implementing this innovative training system.
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Affiliation(s)
- Kengo Kai
- Department of Surgery, University of Miyazaki, Miyazaki, JPN
| | - Hiromi Shinoda
- Department of Nursing, University of Miyazaki Hospital, Miyazaki, JPN
| | - Emi Takeiri
- Department of Nursing, University of Miyazaki Hospital, Miyazaki, JPN
| | - Takeomi Hamada
- Department of Surgery, University of Miyazaki, Miyazaki, JPN
| | - Mayumi Chikubu
- Department of Nursing, University of Miyazaki Hospital, Miyazaki, JPN
| | - Yuko Kodama
- Department of Nursing, University of Miyazaki Hospital, Miyazaki, JPN
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Thompson CM, Bishop MJ, Dillard TC, Maurice JM, Rollins DD, Pulido MD, Salas MJ, Mendelson EA, Yan J, Gerlikovski ER, Benevento SV, Zeinstra C, Kesavadas T. Healing Health Care Disparities: Development and Pilot Testing of a Virtual Reality Implicit Bias Training Module for Physicians in the Context of Black Maternal Health. HEALTH COMMUNICATION 2024:1-12. [PMID: 38711251 DOI: 10.1080/10410236.2024.2347000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Grounded in communication models of cultural competence, this study reports on the development and testing of the first module in a larger virtual reality (VR) implicit bias training for physicians to help them better: (a) recognize implicit bias and its effects on communication, patients, and patient care; (b) identify their own implicit biases and exercise strategies for managing them; and (c) learn and practice communicating with BIPOC patients in a culture-centered manner that demonstrates respect and builds trust. Led by communication faculty, a large, interdisciplinary team of researchers, clinicians, and engineers developed the first module tested herein focused on training goal (a). Within the module, participants observe five scenes between patient Marilyn Hayes (a Black woman) and Dr. Richard Flynn (her obstetrician, a White man) during a postpartum visit. The interaction contains examples of implicit bias, and participants are asked to both identify and consider how implicit bias impacts communication, the patient, and patient care. The team recruited 30 medical students and resident physicians to participate in a lab-based study that included a pretest, a training experience of the module using a head-mounted VR display, and a posttest. Following the training, participants reported improved attitudes toward implicit bias instruction, greater importance of determining patients' beliefs and perspectives for history-taking, treatment, and providing quality health care; and greater communication efficacy. Participants' agreement with the importance of assessing patients' perspectives, opinions, and psychosocial and cultural contexts did not significantly change. Implications for medical education about cultural competency and implicit bias are discussed.
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Affiliation(s)
- Charee M Thompson
- Department of Communication, University of Illinois Urbana-Champaign
| | - Mardia J Bishop
- Department of Communication, University of Illinois Urbana-Champaign
| | | | - Joseph M Maurice
- Department of Obstetrics & Gynecology, Creighton University School of Medicine
| | - Déjà D Rollins
- Department of Communication, University of Illinois Urbana-Champaign
| | - Manuel D Pulido
- Department of Communication Studies, California State University, Long Beach
| | - M J Salas
- School of Communication and Information, Rutgers University
| | - Emily A Mendelson
- Department of Communication, University of Illinois Urbana-Champaign
| | - Jia Yan
- Department of Communication, University of Illinois Urbana-Champaign
| | | | - Sarah V Benevento
- Department of Communication, University of Illinois Urbana-Champaign
| | | | - Thenkurussi Kesavadas
- Division of Research and Economic Development, University at Albany, The State University of New York
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Yu JE. Confirmation of the viability of a metaverse yoga class and investigation into the impact on pain, anxiety, and depression associated with low back pain after engaging in virtual yoga sessions. J Exerc Rehabil 2024; 20:24-33. [PMID: 38433855 PMCID: PMC10902692 DOI: 10.12965/jer.2346586.293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/30/2023] [Accepted: 01/01/2024] [Indexed: 03/05/2024] Open
Abstract
This study aimed to explore the influence of metaverse technology (MT) factors like presence, usability, and enjoyment on patients' satisfaction, with a focus on examining potential mediating effects. In addition, it sought to assess whether the yoga practice as an intervention therapy in MT induces changes in the pain, anxiety, and depression levels of patients experiencing back pain. From the pool of 202 participants, this study chose participants who had reported enduring low back pain over 12 weeks, with a visual analogue scale (VAS) rating of 4 or higher. After completing the questionnaire, patients were randomly assigned to either the control group (COG, n=100) or the yoga exercise group (YEG, n=99). Results showed that the construct validity for questionnaires and a reasonable model fit were confirmed, and that presence showed a statistically significant effect on psychological satisfaction via the mediating path of enjoyment (β=0.592, P=0.001). Following 8 weeks of the yoga practice, the VAS increased for the COG, while it decreased significantly by ~29% for the YEG (P=0.001). YEG also exhibited a decrease in the Oswestry Disability Index by ~17%, anxiety by ~7%, and depression by ~10% (P=0.001). In conclusion, psychological satisfaction in a yoga practice using a metaverse cannot be achieved solely through the sense of presence; enjoyment is necessary for patients' satisfaction. Moreover, it was verified that virtual yoga practice is effective in ameliorating psychological factors resulting from back pain.
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Affiliation(s)
- Ji-Eun Yu
- Research Institute of Sports and Industry Science, Hanseo University, Seosan,
Korea
- Department of Physical Education, Korea University, Seoul,
Korea
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Vaughan N. Virtual Reality Meets Diabetes. J Diabetes Sci Technol 2024:19322968231222022. [PMID: 38193465 DOI: 10.1177/19322968231222022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
BACKGROUND This article provides a detailed summary of virtual reality (VR) and augmented reality (AR) applications in diabetes. The purpose of this comparative review is to identify application areas, direction and provide foundation for future virtual reality tools in diabetes. METHOD Features and benefits of each VR diabetes application are compared and discussed, following a thorough review of literature on virtual reality for diabetes using multiple databases. The weaknesses of existing VR applications are discussed and their strengths identified so that these can be carried forward. A novel virtual reality diabetes tool prototype is also developed and presented. RESULTS This research identifies three major categories where VR is being used in diabetes: education, prevention and treatment. Within diabetes education, there are three target groups: clinicians, adults with diabetes and children with diabetes. Both VR and AR have shown benefits in areas of Type 1 and Type 2 diabetes. CONCLUSIONS Virtual reality and augmented reality in diabetes have demonstrated potential to enhance training of diabetologists and enhance education, prevention and treatment for adults and children with Type 1 or Type 2 diabetes. Future research can continually build on virtual and augmented reality diabetes applications by integrating wide stakeholder inputs and diverse digital platforms. Several areas of VR diabetes are in early stages, with advantages and opportunities. Further VR diabetes innovations are encouraging to enhance training, management and treatment of diabetes.
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Affiliation(s)
- Neil Vaughan
- Department of Clinical and Biomedical Science, NIHR Exeter Biomedical Research Centre, Exeter Centre of Excellence in Diabetes, University of Exeter, Exeter, UK
- Royal Academy of Engineering, London, UK
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Driscoll DL, O'Donnell H, Patel M, Cattell-Gordon DC. Assessing and Addressing the Determinants of Appalachian Population Health: A Scoping Review. JOURNAL OF APPALACHIAN HEALTH 2023; 5:85-102. [PMID: 38784141 PMCID: PMC11110904 DOI: 10.13023/jah.0503.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Introduction Residents of Appalachia experience elevated rates of morbidity and mortality compared to national averages, and these disparities are associated with inequitable exposures to various determinants of population health. Social and environmental determinants of health are a useful lens through which to develop and evaluate programs to mitigate regional health disparities. Methods This 2023 scoping review was conducted of studies linking determinants of Appalachian health with leading causes of regional mortality and morbidity. The search strategy employed a keyword search that included geographic terms for the Appalachian Region and the primary adverse health outcomes in that region. Studies meeting the following inclusion criteria were reviewed: original article, published in the last five years, involving an Appalachian population, and includes a rigorous assessment of an association between a population health determinant and one or more leading causes of Appalachian morbidity and mortality. Results The search returned 221 research articles, including 30 interventional studies. The top three health outcomes included cancer (43.59%), diseases of despair (23.08%), and diabetes (12.82). Access to care (27.3%), rurality (18.9%), and education (14.8%) were the most common population health determinants identified. Interventional studies were categorized by program types: education, technology, partnerships, and multilevel interventions. Due to the heterogeneity of study types, the studies were combined using a narrative synthesis. Implications The results of this work can inform the development and evaluation of additional programs to promote Appalachian population health. Our study team will use these results to inform community-based discussions that develop strategic plans to mitigate health disparities in Central and Southcentral Appalachian Virginia.
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Affiliation(s)
| | | | | | - David C Cattell-Gordon
- Center for Telehealth at the University of Virginia (retired); ThreadEx Consulting LLC (current)
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Love M, Williams ER, Bowditch J. Uses and Considerations for Cinematic Virtual Reality in Health Care. J Diabetes Sci Technol 2023; 17:1154-1159. [PMID: 37300239 PMCID: PMC10563545 DOI: 10.1177/19322968231179730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Through the combination of virtual reality (VR) technology with techniques from theater, filmmaking, and gaming, individuals from the Game Research and Immersive Design Laboratory (GRID Lab) at Ohio University have developed an approach to train soft skills such as communication, problem-solving, teamwork, and interpersonal skills which shows great promise. OBJECTIVES The purpose of this article is to provide an overview of VR and cinematic-VR (cine-VR). This article serves as a preface to the VR research included in this special issue. METHODS In this article, we define VR, review key terminology, present a case study, and offer future directions. RESULTS Prior research with cine-VR has demonstrated the effectiveness in improving provider attitudes and cultural self-efficacy. While cine-VR may differ from other types of VR applications, we have been able to leverage the strengths of cine-VR to create training programs which are user friendly and highly effective. Early projects on diabetes care and opioid use disorder were sufficiently successful that the team received additional funding to pursue series addressing elder abuse/neglect and intimate partner violence. Their work has gone beyond health care and is currently being leveraged for law enforcement training as well. While this article will explore Ohio University's approach to cine-VR training, details of their research including efficacy can be found in McCalla et al, Wardian et al, and Beverly et al. CONCLUSION When produced correctly, cine-VR has the potential to become a mainstay component of training for soft skill applications across a multitude of industries.
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Affiliation(s)
- Matthew Love
- J. Warren McClure School of Emerging
Communication Technologies, Game Research and Immersive Design (GRID) Lab, Ohio University,
Athens, OH, USA
| | - Eric R. Williams
- J. Warren McClure School of Emerging
Communication Technologies, Game Research and Immersive Design (GRID) Lab, Ohio University,
Athens, OH, USA
| | - John Bowditch
- J. Warren McClure School of Emerging
Communication Technologies, Game Research and Immersive Design (GRID) Lab, Ohio University,
Athens, OH, USA
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8
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Bishop E, Allington D, Ringrose T, Martin C, Aldea A, García-Jaramillo M, León-Vargas F, Leal Y, Henao D, Gómez AM. Design and Usability of an Avatar-Based Learning Program to Support Diabetes Education: Quality Improvement Study in Colombia. J Diabetes Sci Technol 2023; 17:1142-1153. [PMID: 36377096 PMCID: PMC10563524 DOI: 10.1177/19322968221136141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND This quality improvement study, entitled Avatar-Based LEarning for Diabetes Optimal Control (ABLEDOC), explored the feasibility of delivering an educational program to people with diabetes in Colombia. The aim was to discover how this approach could be used to improve awareness and understanding of the condition, the effects of treatment, and strategies for effective management of blood-glucose control. METHODS Individuals with diabetes were recruited by Colombian endocrinologists to a human-centered study to codesign the educational program, using the Double Diamond model. Participants contributed to two phases. The first phase focused on gathering unmet educational needs and choice of curriculum. Three prototypes were developed as a result. During phase 2, a different group of participants engaged with the program for several weeks, before reporting back. RESULTS Thirty-six participants completed a Web survey during phase 1, and five were also interviewed by telephone. The majority (33 of 36; 91%) were receptive to the prospect of educational interventions and ranked the chosen topic of hypoglycemia highly. In phase 2, the three prototypes were tested by 17 participants, 10 of whom also gave feedback in focus groups. The response was overwhelmingly positive, with 16 of 17 (94%) stating they would use a program like this again. The 3D version was the most highly rated. CONCLUSIONS Immersive, avatar-based programs, delivered through smartphone, have the potential to deliver educational information that is trusted, engaging, and useful. Future work includes expansion of the curriculum, evaluation with a larger group, and exploration of the prospective role of artificial intelligence in personalizing this form of educational intervention.
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Affiliation(s)
| | | | | | - Clare Martin
- Faculty of Technology, Design and
Environment, Oxford Brookes University, Oxford, UK
| | - Arantza Aldea
- Faculty of Technology, Design and
Environment, Oxford Brookes University, Oxford, UK
| | | | - Fabian León-Vargas
- Faculty of Mechanical, Electronic and
Biomedical Engineering, Universidad Antonio Nariño, Bogotá, Colombia
| | - Yenny Leal
- Institut d’Investigació Biomèdica de
Girona Dr. Josep Trueta, Girona, Spain
| | - Diana Henao
- Endocrinology Unit, Hospital
Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Ana Maria Gómez
- Endocrinology Unit, Hospital
Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
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Wardian JL, Wells TM, Cochran TM. Creating Patient Context: Empathy and Attitudes Toward Diabetes Following Virtual Immersion. J Diabetes Sci Technol 2023; 17:1172-1180. [PMID: 37231650 PMCID: PMC10563534 DOI: 10.1177/19322968231174441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Pandemic circumstances created challenges for doctor of physical therapy (DPT) students to understand social determinants of health (SDH) in clinical rotations. Instead of canceling clinical rotations, a virtual reality cinema (cine-VR) education series was implemented. The purpose of this project is to describe the effect of this simulated immersion on student empathy and attitudes toward diabetes. METHOD The DPT students (n=59) participated in 12 cine-VR education modules, completing surveys at three time points as part of coursework. The students completed baseline measures of the Diabetes Attitude Scale-Version 3 (DAS-3) and Jefferson Empathy Scale (JES), and then were immersed in 12 cine-VR modules. One week after module completion, students participated in a class discussion about the modules. The students repeated the JES and DAS-3 scales at postclass and six weeks later. Three subscales from the Presence Questionnaire (PQ) were used to measure the virtual experience. RESULTS Student scores on three DAS-3 subscales significantly improved on posttest: Attitude toward patient autonomy, Mean: 0.75, SD: 0.45; t(58) = 12.742, P < .001; Psychosocial impact of diabetes, Mean: -0.21, SD: 0.41; t(58) = -3.854, P < .001; and Seriousness of type 2 diabetes, Mean: -039, SD: 0.44; t(58) = -6.780, P < .001, with lower scores six weeks later. Student scores increased on the JES and remained high (P < .001). High subscale scores on the PQ demonstrated immersion and involvement in the virtual experience. DISCUSSION These modules can allow for a shared student experience that improves diabetes attitudes, increases empathy, and fosters meaningful classroom discussion. The cine-VR experience is flexible, and modules allow students to engage in aspects of a patient's life that were not available otherwise.
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Affiliation(s)
- Jana L. Wardian
- Division of Hospital Medicine,
Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE,
USA
| | - Tessa M. Wells
- Division of Physical Therapy Education,
Department of Health & Rehabilitation Sciences, University of Nebraska Medical
Center, Omaha, NE, USA
| | - Teresa M. Cochran
- Division of Physical Therapy Education,
Department of Health & Rehabilitation Sciences, University of Nebraska Medical
Center, Omaha, NE, USA
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Beverly EA, Love C, Love M, Lammert L, Bowditch J. Cinematic Virtual Reality for Educating Health Care Providers About Type 2 Diabetes, Disability, and Elder Abuse and Neglect: A Pilot Study. J Diabetes Sci Technol 2023; 17:1160-1171. [PMID: 37114917 PMCID: PMC10563529 DOI: 10.1177/19322968231171586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND Diabetes care for older adults is complex and must consider geriatric syndromes, disability, and elder abuse and neglect. Health care providers would benefit from professional training programs that emphasize these risks. One new educational approach is cinematic virtual reality (cine-VR). We conducted a pilot study to evaluate a cine-VR training program based on an older patient with type 2 diabetes and multiple geriatric syndromes who is at risk for elder abuse and neglect. METHODS We employed a single-arm, pre-post-test study to assess changes in attitudes to disability and self-efficacy in identifying and managing elder abuse and neglect. RESULTS Thirty health care providers completed the pilot study (83.3% women, 86.7% white, 56.7% physicians, 43.4% practiced in outpatient clinics). We observed change in attitudes toward discrimination (Z = -2.628, P = .009, Cohen's d = .62). In addition, we observed changes in six of the eight self-efficacy items, including how participants would ask questions about abuse (Z = -3.221, P = .001, Cohen's d = .59) and helping an older patient make a report to the police or social services (Z = -2.087, P = .037, Cohen's d = .52). In addition, we observed positive changes in understanding the documentation needed to complete whether a patient reports abuse (Z = -3.598, P < .001) as well as the legal knowledge for how to report elder abuse and neglect (Z = -2.556, P = .011). CONCLUSION Findings from this pilot study suggest that cine-VR training may increase health care providers' awareness of discrimination and improve self-efficacy toward identifying and managing elder abuse and neglect. Research with a proper control condition is needed to confirm its effectiveness.
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Affiliation(s)
- Elizabeth A. Beverly
- Department of Primary Care, Heritage
College of Osteopathic Medicine, Ohio University, Athens, OH, USA
- Diabetes Institute, Ohio University,
Athens, OH, USA
| | - Carrie Love
- Department of Primary Care, Heritage
College of Osteopathic Medicine, Ohio University, Athens, OH, USA
| | - Matthew Love
- J. Warren McClure School of Emerging
Communication Technologies, Ohio University, Athens, OH, USA
- Game Research and Immersive Design
(GRID) Lab, Ohio University, Athens, OH, USA
| | - Lori Lammert
- Department of Primary Care, Heritage
College of Osteopathic Medicine, Ohio University, Athens, OH, USA
- Diabetes Institute, Ohio University,
Athens, OH, USA
| | - John Bowditch
- J. Warren McClure School of Emerging
Communication Technologies, Ohio University, Athens, OH, USA
- Game Research and Immersive Design
(GRID) Lab, Ohio University, Athens, OH, USA
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McCalla MM, Jones D, Grice R, Love M, Love C, Lammert L, Beverly EA. Feasibility of a Cinematic-Virtual Reality Training Program for Health Professional Students: A Single-Arm Pre-Post Study. J Diabetes Sci Technol 2023; 17:1181-1189. [PMID: 37138539 PMCID: PMC10563521 DOI: 10.1177/19322968231171136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
BACKGROUND Cinematic-virtual reality (cine-VR) has demonstrated improvements in cultural self-efficacy, diabetes attitudes, and empathy among healthcare providers, but its impact on health professional students is unknown. The purpose of the single-arm pre-post study was to examine the feasibility of this cine-VR diabetes training program as well as to assess changes in cultural self-efficacy, diabetes attitudes, and empathy among health professional students. METHOD Participants viewed 12 cine-VR 12 simulations about a 72-year-old patient with type 2 diabetes. Pre-training and post-training, they completed the Transcultural Self-Efficacy Tool, Diabetes Attitude Scale-3, and Jefferson Scale of Empathy. RESULTS All 92 participants completed the full training. No participants reported technological difficulties or adverse events. For the assessment, 66 participants completed the pre-post measures for a response rate of 71.7% (mean age = 21.1 ± 1.9 years, 82.6% [n = 57] women; 84.1% [n = 58] white). We observed positive improvements in all three cultural self-efficacy subscales: "Cognitive" (t value = -4.705, P < .001), "Practical" (mean change = -.99, t value = -4.240, P < .001), and "Affective" (t value = -2.763, P = .008). Similarly, we observed positive improvements in four of the five diabetes attitude subscales: "Need for special training" (Z = -4.281, P < .001), "Seriousness of type 2 diabetes" (Z = -3.951, P < .001), "Value of tight glucose control" (Z = -1.676, P = .094), "Psychosocial impact of diabetes" (Z = -5.892, P < .001), and "Attitude toward patient autonomy" (Z = -2.889, P = .005). Finally, we observed a positive improvement in empathy (t value = -5.151, P < .001). CONCLUSIONS Findings suggest that the cine-VR diabetes training program has the potential to improve cultural self-efficacy, diabetes attitudes, and empathy among health professional students. A randomized controlled trial is needed to confirm its effectiveness.
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Affiliation(s)
- Monet M. McCalla
- Department of Primary Care, Ohio
University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - DeWitt Jones
- Department of Primary Care, Ohio
University Heritage College of Osteopathic Medicine, Athens, OH, USA
| | - Re’Aija Grice
- College of Health Sciences and
Professions, Ohio University, Athens, OH, USA
| | - Matthew Love
- Ohio University J. Warren McClure
School of Emerging Communication Technologies, Athens, OH, USA
- Game Research and Immersive Design Lab,
Ohio University, Athens, OH, USA
| | | | - Lori Lammert
- Department of Primary Care, Ohio
University Heritage College of Osteopathic Medicine, Athens, OH, USA
- Ohio University Diabetes Institute,
Athens, OH, USA
| | - Elizabeth A. Beverly
- Department of Primary Care, Ohio
University Heritage College of Osteopathic Medicine, Athens, OH, USA
- Ohio University Diabetes Institute,
Athens, OH, USA
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Lo MF, Ng WCJ, Ng CFG, Ng MLP. The past, present, and future of first aid and health education: a case study in Hong Kong. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2022. [DOI: 10.1108/ijphm-10-2021-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Purpose
The demand for ambulance services in Hong Kong is increasing and first aid plays an important role in saving lives. The government recognized first aid training courses offered by four organizations. This study aims to review and discuss the past, present and future of first aid and health training in Hong Kong.
Design/methodology/approach
This study adopted a case study approach to investigate the operations and development of the first aid and health training in one of the largest training providers in Hong Kong. Publicly available secondary data, including annual reports, websites, newspapers and social media, were collected and analysed. Using the thematic analysis procedure, researchers familiarised the data collected, generated initial codes, searched for themes, reviewed themes, defined themes and reported the results.
Findings
Through data analysis, researchers identified six themes which help to address the research questions regarding the types of first aid and health training courses, quality issue, awareness of first aid in the community and the future delivery of first aid training.
Practical implications
This study provided two implications on both micro and macro levels. At the micro level, training providers can enhance training quality by adopting technology. At the macro level, training providers can continue to advocate and facilitate the integration of first aid into the formal education curriculum. The last section addressed the limitations of this study and provided future research directions.
Originality/value
This study provided insights about the development of the first aid and health education and training. Health-care training providers and policymakers could benchmark the findings from this study and develop appropriate measures for promoting health education.
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Mallik R, Patel M, Atkinson B, Kar P. Exploring the Role of Virtual Reality to Support Clinical Diabetes Training-A Pilot Study. J Diabetes Sci Technol 2022; 16:844-851. [PMID: 34210183 PMCID: PMC9264436 DOI: 10.1177/19322968211027847] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is estimated that 16 to 25% of patients in hospital have diabetes and 1 in 25 inpatients with Type 1 Diabetes develop diabetic ketoacidosis (DKA). It is vital that non-specialist doctors recognize and appropriately manage diabetes emergencies. Simulation training is increasingly being used in healthcare and virtual reality (VR) based educational resources is transforming medical education. This study aimed to evaluate the use of virtual reality to help non-specialist clinicians manage clinical scenarios related to diabetes. METHODS This pilot project, titled 'DEVICE' (Diabetes Emergencies: Virtual Interactive Clinical Education) was developed in collaboration with Oxford Medical Simulation. Fully interactive immersive VR scenarios were created to stimulate real life diabetes emergencies. Users then received personalized feedback and performance metrics. Feedback surveys were provided before and after the participation in the VR scenario. Kirkpatrick's training evaluation model was used. RESULTS Thirty-nine participants from 2 hospitals in UK provided feedback up to 3 months after attending the VR education sessions. Overall feedback was extremely positive, and participants found this immersive teaching experience very helpful. After use of virtual reality scenarios, the mean trainee confidence in managing DKA (on an 8-point Likert scale) increased from 3.92 (3.38-4.47) 95% CI to 5.41 (4.79-6.03) 95% CI (statistically significant). The VR study demonstrates Kirkpatrick level 3 in the follow up survey. CONCLUSION VR based training scenarios in this pilot project increased confidence in managing diabetes emergencies and demonstrated positive changes in their behavior. VR education is a safe, useful and a well-liked training tool for diabetes emergencies.
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Affiliation(s)
- Ritwika Mallik
- Clinical Research Fellow in Diabetes
and Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Mayank Patel
- Consultant in Diabetes and Acute
Medicine, University Hospital Southampton, Southampton, Hampshire, UK
| | - Ben Atkinson
- Consultant in Emergency Medicine,
Wessex Emergency Medicine Simulation Lead, Emergency Department, Portsmouth Hospital
University NHS Trust, Cosham, Portsmouth, UK
| | - Partha Kar
- National Specialty Advisor, Diabetes
with NHS England, Consultant in Diabetes & Endocrinology, Portsmouth Hospital
University NHS Trust, Cosham, Portsmouth, UK
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Beverly E, Rigot B, Love C, Love M. Perspectives of 360-Degree Cinematic Virtual Reality: Interview Study Among Health Care Professionals. JMIR MEDICAL EDUCATION 2022; 8:e32657. [PMID: 35486427 PMCID: PMC9107048 DOI: 10.2196/32657] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/20/2021] [Accepted: 03/22/2022] [Indexed: 05/19/2023]
Abstract
BACKGROUND The global market for medical education is projected to increase exponentially over the next 5 years. A mode of delivery expected to drive the growth of this market is virtual reality (VR). VR simulates real-world objects, events, locations, and interactions in 3D multimedia sensory environments. It has been used successfully in medical education for surgical training, learning anatomy, and advancing drug discovery. New VR research has been used to simulate role-playing and clinical encounters; however, most of this research has been conducted with health professions students and not current health care professionals. Thus, more research is needed to explore how health care professionals experience VR with role-playing and clinical encounters. OBJECTIVE The aim of this study was to explore health care professionals' experiences with a cinematic VR (cine-VR) training program focused on role-playing and clinical encounters addressing social determinants of health, Appalachian culture, and diabetes. Cine-VR leverages 360-degree video with the narrative storytelling of cinema to create an engaging educational experience. METHODS We conducted in-depth telephone interviews with health care professionals who participated in the cine-VR training. The interviews were audio recorded and transcribed verbatim. A multidisciplinary team coded and analyzed the data using content and thematic analyses with NVivo software. RESULTS We conducted 24 in-depth interviews with health care professionals (age=45.3, SD 11.3, years; n=16, 67%, women; n=22, 92%, White; and n=4, 17%, physicians) to explore their experiences with the cine-VR training. Qualitative analysis revealed five themes: immersed in the virtual world: seeing a 360-degree sphere allowed participants to immerse themselves in the virtual world; facilitated knowledge acquisition: all the participants accurately recalled the culture of Appalachia and listed the social determinants of health presented in the training; empathized with multiple perspectives: the cine-VR provided a glimpse into the real life of the main character, and participants described thinking about, feeling, and empathizing with the character's frustrations and disappointments; perceived ease of use of cine-VR: 96% (23/24) of the participants described the cine-VR as easy to use, and they liked the 360-degree movement, image resolution, and sound quality but noted limitations with the buttons on the headsets and risk for motion sickness; and perceived utility of cine-VR as a teaching tool: participants described cine-VR as an effective teaching tool because it activated visual and affective learning for them. CONCLUSIONS Participants emphasized the realism of the cine-VR training program. They attributed the utility of the cine-VR to visual learning in conjunction with the emotional connection to the VR characters. Furthermore, participants reported that the cine-VR increased their empathy for people. More research is needed to confirm an association between the level of immersion and empathy in cine-VR training for health care professionals.
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Affiliation(s)
- Elizabeth Beverly
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | - Brooke Rigot
- Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
| | - Carrie Love
- J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
| | - Matt Love
- J Warren McClure School of Emerging Communication Technologies, Ohio University, Athens, OH, United States
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