1
|
Bruton L, Nunes D, Quadri M. Scoping Review of Pediatric Primary Care Educational Literature. Clin Pediatr (Phila) 2024:99228241274905. [PMID: 39158507 DOI: 10.1177/00099228241274905] [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: 08/20/2024]
Abstract
Primary care pediatrics is an important element of pediatric training at all levels, yet trainees often lack clinical competence in this area. This scoping review sought to identify the current research available related to pediatric primary care education for medical students and residents and gaps/areas for improvement. Searches were completed on PubMed MEDLINE, Embase, Scopus, and MedEdPORTAL using the search terms "pediatrics," "education," "curricula," and "primary care." An initial total of 6499 articles was screened down to 102 articles for the final full text review and extraction. The most frequently encountered educational subjects were child development and developmental screening (8.8%), adolescent substance use (7.8%), and vaccines/vaccine hesitancy (6.9%). Several subject areas were underrepresented, including pubertal assessment (0.9%), transgender medicine (0.9%), child passenger safety (0.9%), discipline (0.9%), and sports/orthopedic medicine (0%). This study shows that future pediatric primary care educational studies and innovations are needed to improve trainee competence and comfort.
Collapse
Affiliation(s)
- Lucas Bruton
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Denise Nunes
- Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Maheen Quadri
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
2
|
Huber L, Good R, Bone MF, Flood SM, Fredericks R, Overly F, Tofil NM, Wing R, Walsh K. A Modified Delphi Study for Curricular Content of Simulation-Based Medical Education for Pediatric Residency Programs. Acad Pediatr 2024; 24:856-865. [PMID: 38663801 DOI: 10.1016/j.acap.2024.04.008] [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] [Received: 12/19/2023] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE We sought to establish core knowledge topics and skills that are important to teach pediatric residents using simulation-based medical education (SBME). METHODS We conducted a modified Delphi process with experts in pediatric SBME. Content items were adapted from the American Board of Pediatrics certifying exam content and curricular components from pediatric entrustable professional activities (EPAs). In round 1, participants rated 158 items using a four-point Likert scale of importance to teach through simulation in pediatric residency. A priori, we defined consensus for item inclusion as ≥70% rated the item as extremely important and exclusion as ≥70% rated the item not important. Criteria for stopping the process included reaching consensus to include and/or exclude all items, with a maximum of three rounds. RESULTS A total of 59 participants, representing 46 programs and 25 states participated in the study. Response rates for the three rounds were 92%, 86% and 90%, respectively. The final list includes 112 curricular content items deemed by our experts as important to teach through simulation in pediatric residency. Seventeen procedures were included. Nine of the seventeen EPAs had at least one content item that experts considered important to teach through simulation as compared to other modalities. CONCLUSIONS Using consensus methodology, we identified the curricular items important to teach pediatric residents using SBME. Next steps are to design a simulation curriculum to encompass this content.
Collapse
Affiliation(s)
- Lorel Huber
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo.
| | - Ryan Good
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Meredith F Bone
- University of Colorado (L Huber, R Good, and MF Bone), Pediatric Critical Care Medicine, Aurora, Colo
| | - Shannon M Flood
- University of Colorado (SM Flood), Pediatric Emergency Medicine, Aurora, Colo
| | - Ryan Fredericks
- Swedish Medical Center (R Fredericks), Pediatric Critical Care Medicine, Seattle, Wash
| | - Frank Overly
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Nancy M Tofil
- University of Alabama at Birmingham (NM Tofil), Pediatric Critical Care Medicine, Birmingham, Ala
| | - Robyn Wing
- Alpert Medical School of Brown University and Rhode Island Hospital/Hasbro Children's Hospital (F Overly and R Wing), Pediatric Emergency Medicine, Providence, RI
| | - Kathryn Walsh
- University of Colorado (K Walsh), Denver Health, Pediatric Critical Care Medicine, Denver Health Medical Center, Denver, Colo
| |
Collapse
|
3
|
Yoo S, Son MH. Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics. Clin Exp Pediatr 2024; 67:92-103. [PMID: 37232076 PMCID: PMC10839193 DOI: 10.3345/cep.2022.00731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND COVID-19 pandemic has significantly impacted the field of medical training, necessitating innovative approaches to education and practice. During this period, the use of novel technologies like virtual reality (VR), augmented reality (AR), and mixed reality (MR) has become increasingly vital. These technologies offer the advantage of transcending the limitations of time and space, thus enabling medical professionals to access various personalized programs for both education and service delivery. This shift is particularly relevant in the realm of pediatric medicine, where traditional training and clinical methods face unique challenges. PURPOSE The primary aim of this study is to explore the application of VR, AR, and MR technologies in pediatric medical settings, with a focus on both clinical applications and the training of pediatric medical professionals. We aim to comprehensively search and review studies that have utilized these technologies in the treatment of pediatric patients and the education of healthcare providers in this field. METHODS Peer-reviewed articles published in PubMed, the Cochrane Library, ScienceDirect, Google Scholar, and Scopus from January 1, 2018, to March 1, 2023, were comprehensively searched. The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic review and Meta-Analyses) guidelines. Among the 89 studies, 63 investigated the clinical applications of VR (n=60) or AR (n=3) in pediatric patients, and 25 investigated the applications of VR (n=19), AR (n=5), or MR (n=1) for training medical professionals. RESULTS A total of 36 randomized controlled trials (RCTs) for clinical application (n=31) and medical training (n=5) were retrieved. Among the RCTs, 21 reported significant improvements in clinical applications (n=17) and medical training (n=4). CONCLUSION Despite a few limitations in conducting research on innovative technology, such research has rapidly expanded, indicating that an increasing number of researchers are involved in pediatric research using these technologies.
Collapse
Affiliation(s)
- Suyoung Yoo
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
| | - Meong Hi Son
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
4
|
Moore DJ, Bradner MK, Strayer SM, Santen SA, Edwards C, Hayes RB, Cronholm PF. Motivational Interviewing Education in North American Family Medicine Clerkships: A CERA Study. Fam Med 2023; 55:598-606. [PMID: 37540536 PMCID: PMC10622121 DOI: 10.22454/fammed.2023.476432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Many health conditions are preventable or modifiable through behavioral changes. Motivational interviewing (MI) is an evidence-based communication technique that explores a patient's reasons for behavioral changes. This study assesses the current landscape of MI training in North American Family Medicine (FM) clerkships. METHODS We analyzed data gathered as part of the 2022 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of FM clerkship directors (CDs). The survey was distributed via email invitation to 159 US and Canadian FM CDs in June 2022. RESULTS Of the 94 responses received, 61% indicated that MI training is provided in their FM clerkship. Medical school type, class size, and location were associated with MI training priority, offerings, and duration in the clerkship, respectively. CD experience correlated with MI training duration; student MI skill training level was associated with MI training duration and priority; the rigor of student MI skills evaluation was correlated with MI teaching methods and training duration; self-reported student MI competency was associated with the length of time students spent with FM community preceptors as well as MI training priority and teaching methods; and several items emerged as predictors of student, CD, and FM faculty MI training expansion. CONCLUSIONS Opportunities exist to enhance the volume, content, and rigor of MI training in North American FM clerkships as well as to improve self-reported student MI competency within those clerkships.
Collapse
Affiliation(s)
- Denee J. Moore
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Melissa K. Bradner
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Scott M. Strayer
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Sally A. Santen
- Office of Assessment, Evaluation, and Scholarship, Virginia Commonwealth University School of MedicineRichmond, VA
- Department of Emergency Medicine, Virginia Commonwealth University School of MedicineRichmond, VA
- Department of Emergency Medicine, University of CincinnatiCincinnati, OH
| | - Cherie Edwards
- Office of Assessment, Evaluation, and Scholarship, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Rashelle B. Hayes
- Department of Psychiatry, Virginia Commonwealth University School of MedicineRichmond, VA
| | - Peter F. Cronholm
- Department of Family Medicine and Community Health, Center for Public Health Initiatives, Leonard Davis Institute of Health Economics, University of Pennsylvania School of MedicinePhiladelphia, PA
| |
Collapse
|
5
|
Odum JD, Real FJ, Rice J, Meisman A, Sahay R, Zhang B, Zackoff MW. Virtual Reality to Assess Resident Recognition of Impending Respiratory Failure During COVID-19. Hosp Pediatr 2023; 13:e135-e139. [PMID: 37232100 DOI: 10.1542/hpeds.2022-006917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES To assess the performance of pediatric residents in recognizing a decompensating patient with impending respiratory failure and appropriately escalating care using a virtual reality (VR) simulated case of an infant with bronchiolitis after an extended period of decreased clinical volumes during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Sixty-two pediatric residents at a single academic pediatric referral center engaged in a 30-minute VR simulation on respiratory failure in a 3-month-old admitted to the pediatric hospital medicine service with bronchiolitis. This occurred in a socially distant manner across the Zoom platform during the COVID-19 pandemic (January-April 2021). Residents were assessed on their ability to (1) recognize altered mental status (AMS), (2) designate clinical status as "(impending) respiratory failure," and (3) escalate care. Statistical differences between and across postgraduate year (PGY) levels were examined using χ2 or Fisher's exact test, followed by pairwise comparison and posthoc multiple testing using the Hochberg test. RESULTS Among all residents, 53% successfully recognized AMS, 16% identified respiratory failure, and 23% escalated care. No significant differences were seen across PGY levels for recognizing AMS or identifying respiratory failure. PGY3+ residents were more likely to escalate care than PGY2 residents (P = .05). CONCLUSIONS In the setting of an extended period with decreased clinical volumes during the COVID-19 pandemic, pediatric residents across all PGY levels demonstrated challenges with identifying (impending) respiratory failure and appropriately escalating care during VR simulations. Though limited, VR simulation may serve as a safe adjunct for clinical training and assessment during times of decreased clinical exposure.
Collapse
Affiliation(s)
- James D Odum
- Division of Critical Care
- Department of Pediatrics
| | - Francis J Real
- Division of General and Community Pediatrics
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | | | - Rashmi Sahay
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Matthew W Zackoff
- Division of Critical Care
- Department of Pediatrics
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| |
Collapse
|
6
|
Sadek O, Baldwin F, Gray R, Khayyat N, Fotis T. Impact of Virtual and Augmented Reality on Quality of Medical Education During the COVID-19 Pandemic: A Systematic Review. J Grad Med Educ 2023; 15:328-338. [PMID: 37363680 PMCID: PMC10286921 DOI: 10.4300/jgme-d-22-00594.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 10/20/2022] [Accepted: 03/22/2023] [Indexed: 06/28/2023] Open
Abstract
Background The COVID-19 pandemic and the subsequent mandatory social distancing led to widespread disruption of medical education. This contributed to the accelerated introduction of virtual reality (VR) and augmented reality (AR) technology in medical education. Objective The objective of this quantitative narrative synthesis review is to summarize the recent quantitative evidence on the impact of VR and AR on medical education. Methods A literature search for articles published between March 11, 2020 and January 31, 2022 was conducted using the following electronic databases: Embase, PubMed, MEDLINE, CINAHL, PsycINFO, AMED, EMCARE, BNI, and HMIC. Data on trainee confidence, skill transfer, information retention, and overall experience were extracted. Results The literature search generated 448 results, of which 13 met the eligibility criteria. The studies reported positive outcomes in trainee confidence and self-reported knowledge enhancement. Additionally, studies identified significant improvement in the time required to complete surgical procedures in those trained on VR (mean procedure time 97.62±35.59) compared to traditional methods (mean procedure time 121.34±12.17). However, participants also reported technical and physical challenges with the equipment (26%, 23 of 87). Conclusions Based on the studies reviewed, immersive technologies offer the greatest benefit in surgical skills teaching and as a replacement for lecture- and online-based learning. The review identified gaps that could be areas for future research.
Collapse
Affiliation(s)
- Omar Sadek
- All authors are with Brighton and Sussex Medical School, Brighton, England
- Omar Sadek, A Levels, is a Medical Student
| | - Fiona Baldwin
- All authors are with Brighton and Sussex Medical School, Brighton, England
- Fiona Baldwin, MBBS, is a Consultant, Intensive Care Medicine
| | - Rebecca Gray
- All authors are with Brighton and Sussex Medical School, Brighton, England
- Rebecca Gray, MBBS, is a Consultant, Intensive Care Medicine
| | - Nadine Khayyat
- All authors are with Brighton and Sussex Medical School, Brighton, England
- Nadine Khayyat, A Levels, is a Medical Student
| | - Theofanis Fotis
- All authors are with Brighton and Sussex Medical School, Brighton, England
- Theofanis Fotis, PhD, is Principal Lecturer, Associate Director (Outreach) Research Centre for Secure Intelligent & Usable Systems, and Academic Lead, Brighton and Hove Digital Health Living Lab, School of Health Science
| |
Collapse
|
7
|
Westers NJ, Needham HE, Walsh JB. Effectiveness of a Curriculum for Pediatric Residents to Address Adolescent Nonsuicidal Self-Injury. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2023; 47:18-24. [PMID: 35854174 PMCID: PMC9296118 DOI: 10.1007/s40596-022-01684-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The present study assessed changes in pediatric resident competence in addressing adolescent nonsuicidal self-injury (NSSI) following a brief, single-session didactic training during the educational unit in adolescent medicine. This study also evaluated knowledge acquisition and retention over time, overall helpfulness of the training, and changes in the perception of how important residents believe that physicians receive training in NSSI. METHODS Pediatric residents participated in a single-session NSSI curriculum delivered as part of a monthlong clinical rotation from August 2016 to February 2019. Participants completed pretest, posttest, and 6-month follow-up surveys, and t tests and analyses of variance with post hoc comparisons evaluated changes in variables across the three time points. RESULTS One hundred twenty-seven of 162 eligible residents participated (78.4% response rate), and 69 completed the 6-month follow-up (54.3% retention rate). Prior to the NSSI didactic, 107 (85.6%) reported feeling not at all competent or only somewhat competent in responding to patients with a history of NSSI. Residents' self-perceived competence increased significantly (p < .001) from pretest to posttest and was sustained longitudinally. A measure of objective knowledge also showed retention over time. Residents were significantly (p < .001) more likely after the didactic to believe that training in NSSI for physicians is very important compared to before the training. CONCLUSIONS Following NSSI training, residents demonstrated increased knowledge and subjective competence in caring for adolescents who self-injure. It is feasible and important to integrate a brief, single-session NSSI curriculum into pediatric residency programs, such as in the adolescent medicine rotation.
Collapse
Affiliation(s)
| | - Heather E Needham
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Jennifer B Walsh
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
8
|
A Virtual Reality Curriculum to Enhance Residents' Behavioral Health Anticipatory Guidance Skills: A Pilot Trial. Acad Pediatr 2023; 23:185-192. [PMID: 35870801 DOI: 10.1016/j.acap.2022.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 06/27/2022] [Accepted: 07/04/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Effective educational strategies to train and assess residents' skills in behavioral health competencies have been limited. We hypothesized that a training curriculum using virtual reality (VR) simulations would enhance residents' evidence-based skills related to behavioral health anticipatory guidance (BHAG) and motivational interviewing (MI). METHODS We conducted a randomized controlled pilot trial of our curriculum within an urban academic clinic. Intervention and control groups received four 15-minute, monthly didactics on BHAG and MI followed by VR simulations to 1) deliberately practice delivering BHAG by verbally counseling avatars, who responded real-time (intervention group) or 2) assessing pediatric respiratory distress (control group). Two months post-VR training, all residents participated in a unique VR behavioral health scenario which was recorded and coded by pediatric psychologists via an observation instrument to assess residents' skills. Differences in BHAG and MI competencies were assessed via independent samples t tests for continuous variables and Fisher's exact tests for categorical variables. RESULTS Sixty-six percent (n = 55) of eligible residents completed all study protocols comprising 35 intervention and 20 control participants. Intervention participants demonstrated an increase in BHAG skills (P = .002), percentage of open-ended questions asked (P = .04), and percentage of MI adherent behaviors (P = .04) when compared to the control group. CONCLUSIONS VR may be an effective educational strategy for residents to acquire BHAG and MI skills though deliberate practice. Next steps will focus on assessing the generalizability of the VR curriculum as well as exploring the opportunities to enhance its scalability through artificial intelligence.
Collapse
|
9
|
Frey-Vogel AS, Ching K, Dzara K, Mallory L. The Acceptability of Avatar Patients for Teaching and Assessing Pediatric Residents in Communicating Medical Ambiguity. J Grad Med Educ 2022; 14:696-703. [PMID: 36591423 PMCID: PMC9765906 DOI: 10.4300/jgme-d-22-00088.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 07/08/2022] [Accepted: 09/27/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Simulation offers a means to assess resident competence in communication, but pediatric standardized patient simulation has limitations. A novel educational technology, avatar patients (APs), holds promise, but its acceptability to residents, educational relevance, and perception of realism have not been determined. OBJECTIVE To determine if APs are acceptable, provide a relevant educational experience, and are realistic for teaching and assessment of a complex communication topic. METHODS Pediatric residents at one academic institution participated in an AP experience from 2019 to 2021 consisting of 2 scenarios representing issues of medical ambiguity. After the experience, residents completed a survey on the emotional relevance, realism, and acceptability of the technology for assessment of their communication competence. RESULTS AP actor training required approximately 3 hours. Software and training was provided free of charge. Actors were paid $30/hour; the total estimated curricular cost is $50,000. Sixty-five of 89 (73%) pediatric residents participated in the AP experience; 61 (93.8%) completed the survey. Forty-eight (78.7%) were emotionally invested in the scenarios. The most cited emotions evoked were anxiety, uncertainty, concern, and empathy. The conversations were rated by 49 (80.3%) as realistic. APs were rated as beneficial for learning to communicate about medical ambiguity by 40 (65.5%), and 41 (66.7%) felt comfortable having APs used to assess their competence in this area. CONCLUSIONS Pediatric residents were emotionally invested in the AP experience and found it to be realistic. The experience was rated as beneficial for learning and acceptable to be used for assessment of how to communicate medical ambiguity.
Collapse
Affiliation(s)
- Ariel S. Frey-Vogel
- Ariel S. Frey-Vogel, MD, MAT, is Director, Pediatric Education, Innovation and Research Center, and Associate Program Director, Pediatric Residency Program, Harvard Medical School and Mass General for Children
| | - Kevin Ching
- Kevin Ching, MD, is Medical Director, Weill Cornell Medicine New York Presbyterian Simulation Center
| | - Kristina Dzara
- Kristina Dzara, PhD, MMSc, is Assistant Dean for Educator Development and Director, Center for Leadership and Innovation in Medical Education, Department of Biomedical Informatics and Medical Education, and Center for Leadership and Innovation in Medical Education, University of Washington School of Medicine
| | - Leah Mallory
- Leah Mallory, MD, is Medical Director, The Hannaford Center for Safety, Innovation, and Simulation, The Barbara Bush Children's Hospital at Maine Medical Center
| |
Collapse
|
10
|
Real FJ, Ollberding NJ, Meisman AR, DeBlasio DJ, Pero MB, Davis D, Cruse B, Klein MD, Kahn JA, Rosen BL. Impact of a Virtual Reality Curriculum on Human Papillomavirus Vaccination: A Pilot Trial. Am J Prev Med 2022; 63:865-873. [PMID: 35778065 PMCID: PMC9639394 DOI: 10.1016/j.amepre.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/18/2022] [Accepted: 05/04/2022] [Indexed: 11/01/2022]
Abstract
Although the strongest predictor of human papillomavirus (HPV) vaccination is a high-quality recommendation, physicians often provide weak recommendations. Thus, the authors developed Virtual Immersive Communication Training on Recommending Immunizations (VICTORI), a virtual reality (VR)‒based intervention that provided physicians the opportunity to deliberately practice recommendation behaviors. VICTORI included VR simulations during which participants counseled caregiver avatars hesitant to vaccinate. Before participation in VICTORI, participants reviewed a smartphone application on recommendation behaviors. A nonrandomized control trial of VICTORI was conducted with licensed and resident physicians. The intervention group completed the application and VICTORI simulations, whereas a comparison group completed only the application. The hypothesis was that HPV vaccination rates would increase for patients in the intervention group. The preintervention period was defined as the 6 months before allocated training (February 1, 2020-July 31, 2020), and the postintervention period was the 6 months after (October 1, 2020-March 31, 2021). The primary outcome was a change in the rates of human papillomavirus vaccine initiation among eligible patients presenting to clinic before and after. Of 142 eligible physicians, 134 (94%) chose to participate, with 93 of /97 (96%) intervention and 30 of 37 (81%) comparison participants completing study protocols. There was a statistically significant increase in patients' HPV vaccine initiation rates after training within the intervention group (54.3%‒72.4%; 18.1% difference [95% CI=11.0, 25.8]; p<0.001) but not within the comparison group (59.5%‒63.4%; 3.9% difference [95% CI= -11.0, 19.0]; p=0.609). In conclusion, HPV vaccine initiation increased after VR training, and further study is warranted.
Collapse
Affiliation(s)
- Francis J Real
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Nicholas J Ollberding
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Andrea R Meisman
- Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Dominick J DeBlasio
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Mary Beth Pero
- Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - David Davis
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Bradley Cruse
- Center for Simulation and Research, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Melissa D Klein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Jessica A Kahn
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Brittany L Rosen
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Adolescent and Transition Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| |
Collapse
|
11
|
Early Outcomes from a Pediatric Education Research Unit. J Pediatr 2022; 249:3-5.e1. [PMID: 35227756 DOI: 10.1016/j.jpeds.2022.02.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 02/22/2022] [Indexed: 11/21/2022]
|
12
|
Pallavicini F, Pepe A, Clerici M, Mantovani F. Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review (Preprint). JMIR Serious Games 2021; 10:e35000. [PMID: 36282554 PMCID: PMC9605086 DOI: 10.2196/35000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 04/18/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. Objective This systematic review aimed to describe the literature on health care–targeted virtual reality applications during the COVID-19 crisis. Methods We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: “[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)].” Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. Conclusions Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. Trial Registration International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/
Collapse
Affiliation(s)
- Federica Pallavicini
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Alessandro Pepe
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Fabrizia Mantovani
- Department of Human Sciences for Education, Università degli Studi di Milano-Bicocca, Milano, Italy
- Gamers VR Lab, Università degli Studi di Milano-Bicocca, Milano, Italy
| |
Collapse
|