Torres Andrei, Nguyen Binh, Kapralos Bill, Krishnan Sridhar, Campbell Douglas M, Beavers Lindsay, Dubrowski Adam, Bhat Venkat
maxSIMhealth Group, Ontario Tech University, Oshawa, CAN.
Electrical, Computer, and Biomedical Engineering, Toronto Metropolitan University, Toronto, CAN.
Cureus. 2024 Feb 2;16(2):e53450. doi: 10.7759/cureus.53450. eCollection 2024 Feb.
Healthcare providers, particularly during the COVID-19 crisis, have been forced to make difficult decisions and have reported acting in ways that are contrary to their moral values, integrity, and professional commitments, given the constraints in their work environments. Those actions and decisions may lead to healthcare providers' moral suffering and distress. This work outlines the development of the Moral Distress Virtual Reality Simulator (Moral Distress VRS) to research stress and moral distress among healthcare workers during the COVID-19 pandemic. The Moral Distress VRS was developed based on the agile methodology framework, with three simultaneous development streams. It followed a two-week sprint cycle, ending with meetings with stakeholders and subject matter experts, whereby the project requirements, scope, and features were revised, and feedback was provided on the prototypes until reaching the final prototype that was deployed for in-person study sessions. The final prototype had two user interfaces (UIs), one for the participant and one for the researcher, with voice narration and customizable character models wearing medical personal protective equipment, and followed a tree-based dialogue scenario, outputting a video recording of the session. The virtual environment replicated an ICU nursing station and a fully equipped patient room. We present the development process that guided this project, how different teams worked together and in parallel, and detail the decisions and outcomes in creating each major component within a limited deadline. Finally, we list the most significant challenges and difficulties faced and recommendations on how to solve them.
医疗服务提供者，尤其是在新冠疫情危机期间，由于工作环境的限制，被迫做出艰难的决定，并报告称其行为方式违背了他们的道德价值观、正直品质和职业承诺。这些行为和决定可能会导致医疗服务提供者的道德痛苦和困扰。这项工作概述了道德痛苦虚拟现实模拟器（Moral Distress VRS）的开发过程，以研究新冠疫情期间医护人员的压力和道德痛苦。道德痛苦虚拟现实模拟器是基于敏捷方法框架开发的，有三个同步的开发流程。它遵循为期两周的冲刺周期，最后与利益相关者和主题专家开会，据此修订项目要求、范围和功能，并对原型提供反馈，直到达到用于现场研究环节的最终原型。最终原型有两个用户界面（UI），一个供参与者使用，一个供研究人员使用，带有语音旁白和可定制的穿着医用个人防护装备的角色模型，并遵循基于树状的对话场景，输出该环节的视频记录。虚拟环境复制了一个重症监护病房护理站和一个设备齐全的病房。我们展示了指导该项目的开发过程、不同团队如何协同及并行工作，并详细介绍了在有限期限内创建每个主要组件时的决策和成果。最后，我们列出了面临的最重大挑战和困难以及解决这些问题的建议。
