Neher Andrea N, Wespi Rafael, Rapphold Benjamin D, Sauter Thomas C, Kämmer Juliane E, Birrenbach Tanja
Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
JMIR Serious Games. 2024 Nov 4;12:e57117. doi: 10.2196/57117.
Effective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)-based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning.
This study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case.
This 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course.
The data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65-80). The perception of usefulness (median 6, IQR 5.8-6.9) and ease of use (median 5.9, IQR 5.1-6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6-9) to posttraining (median 8, IQR 7-9; z=-2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2-3 and median 3.5, IQR 3-4, respectively; z=-3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely.
The new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students.
有效的跨专业团队合作对于确保高质量的患者护理至关重要，尤其是在急诊医学领域。然而，跨专业教育往往无法促进医疗保健各学科之间有意义的互动。因此，必须尽早提供培养跨专业团队合作技能的机会。虽然基于现场模拟的培训已被证明能提高表现，但这需要大量资源，特别是如果涉及多个专业。基于虚拟现实（VR）的培训是一种创新的教学方法，所需资源较少，并提供了不受地点限制的学习灵活性。
本研究旨在开发并评估一个跨专业团队（INTEAM）培训课程的接受度、学习成果和可行性，该课程包括一个神经科急诊病例的VR模拟。
这项单组研究采用前后测试设计，以评估针对护理和医学专业学生的两小时INTEAM培训课程。该课程包括一个电子学习部分、VR模拟和汇报环节。主要学习目标源自可托付专业活动6，即处理急诊医学中的一个常见问题（蛛网膜下腔出血和癫痫发作所致头痛），这需要跨专业协作，包括结构化的交接班。我们使用经过验证的和自行构建的问卷、前后测试以及开放式问题来评估该课程的接受度、学习成果和可行性。
对42名学生（21名护理专业学生和21名医学专业学生）的数据进行了分析，结果显示在系统可用性量表中具有良好的可用性（中位数72.5，四分位距65 - 80）。所有学生对有用性的感知（中位数6，四分位距5.8 - 6.9）和易用性（中位数5.9，四分位距5.1 - 6.3）都很好。交接班表现从培训前（中位数8，四分位距6 - 9）到培训后有显著提高（中位数8，四分位距7 - 9；z = -2.01；P = 0.045；r = 0.33），对癫痫患者护理的信心也有提高（分别为中位数3，四分位距2 - 3和中位数3.5，四分位距3 - 4；z = -3.8；P < 0.001；r = 0.60）。在67%（14/21）的模拟中出现了技术问题，但所有模拟都能完全进行。
新的INTEAM培训课程受到了护理和医学专业学生的好评。课程结束后，交接班技能以及对癫痫患者护理的信心得到了提高。尽管VR模拟存在技术挑战，但没有一个需要终止，这表明我们的方法是可行的。这些有前景的结果鼓励在护理和医学专业学生的教育中使用VR模拟进行团队培训。
