UCAM Universidad Católica de Murcia, Murcia, España.
Gerencia de Urgencias y Emergencias 061 de la Región de Murcia, Murcia, España.
Medicine (Baltimore). 2023 Jan 27;102(4):e32736. doi: 10.1097/MD.0000000000032736.
BACKGROUND: Virtual reality (VR) is an interesting and promising way to teach cardiopulmonary resuscitation (CPR) to adult laypersons as its high immersive characteristics could improve the level of skills and acquired knowledge in learning basic life support (BLS). METHODS: This systematic review assesses current literature about BLS training with VR and its possible effect on CPR-quality parameters, self-efficacy, perceived learning, and learners' satisfaction and short and long-term patients' outcome. We screened the Cochrane Library, PubMed, CINAHL, MEDLINE Ovid, Web of Science, and Scopus databases and included only clinical trials and quasi-experimental studies published from inception to October 1, 2021, which analyzed adult laypersons' BLS training with the use of VR. Primary outcomes were CPR parameters (chest compression rate and depth, Automated External Defibrillator use). Secondary outcomes were self-efficacy, perceived learning and learners satisfaction, and patients' outcomes (survival and good neurologic status). The risk of bias of included study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions tool to evaluate randomized control trials and the transparent reporting of evaluations with nonrandomized designs checklist for nonrandomized studies. RESULTS: After full article screening, 6 studies were included in the systematic review (731 participants) published between 2017 and 2021. Because of the heterogeneity of the studies, we focused on describing the studies rather than meta-analysis. The assessment of the quality of evidence revealed overall a very low quality. Training with VR significantly improved the rate and depth of chest compressions in 4 out of 6 articles. VR was described as an efficient teaching method, exerting a positive effect on self-efficacy, perception of confidence, and competence in 2 articles. CONCLUSION: VR in BLS training improves manual skills and self-efficacy of adult laypersons and may be a good teaching method in a blended learning CPR training strategy. VR may add another way to divide complex parts of resuscitation training into easier individual skills. However, the conclusion of this review suggests that VR may improve the quality of the chest compressions as compared to instructor-led face-to-face BLS training.
背景:虚拟现实(VR)是一种有趣且有前途的教授成人非专业人士心肺复苏术(CPR)的方法,因为其高沉浸式的特点可以提高学习基本生命支持(BLS)的技能水平和获得的知识。
方法:本系统评价评估了目前关于 VR 进行 BLS 培训的文献及其对 CPR 质量参数、自我效能感、感知学习以及学习者满意度和短期及长期患者结果的可能影响。我们筛选了 Cochrane 图书馆、PubMed、CINAHL、MEDLINE Ovid、Web of Science 和 Scopus 数据库,仅纳入从开始到 2021 年 10 月 1 日发表的分析成人非专业人士使用 VR 进行 BLS 培训的临床试验和准实验研究。主要结局为 CPR 参数(胸外按压频率和深度、自动体外除颤器的使用)。次要结局为自我效能感、感知学习和学习者满意度以及患者结局(生存和良好的神经状态)。使用 Cochrane 系统评价干预手册评估随机对照试验,使用非随机设计透明报告评价检查表评估非随机研究,对纳入研究的偏倚风险进行评估。
结果:经过全文筛选,有 6 项研究(731 名参与者)被纳入 2017 年至 2021 年发表的系统评价。由于研究的异质性,我们侧重于描述研究而不是进行 meta 分析。证据质量评估显示总体质量非常低。6 篇文章中有 4 篇报道 VR 培训显著提高了胸外按压的频率和深度。2 篇文章报道 VR 被描述为一种有效的教学方法,对自我效能感、信心感知和能力产生积极影响。
结论:BLS 培训中的 VR 提高了成人非专业人士的手动技能和自我效能感,并且可能是混合式 CPR 培训策略中的一种良好教学方法。VR 可能为将复苏培训的复杂部分分解为更容易的单个技能提供另一种方法。然而,本综述的结论表明,与由导师主导的面对面 BLS 培训相比,VR 可能会提高胸外按压的质量。
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