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1.
Asian Nurs Res (Korean Soc Nurs Sci) ; 15(5): 345-352, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1594617

ABSTRACT

PURPOSE: The purpose of this study was to develop a novel mouth contactless breathing exercise solution based on virtual reality (VR), and to test its feasibility. METHODS: We developed the Virtual Reality-based Breathing Exercise System (VR-BRES), a self-regulating biofeedback breathing exercise with gaming characteristics and a soft stretch sensor. The feasibility and efficacy of the VR-BRES prototype were investigated through a randomized crossover trial. Fifty healthy adults participated in the trial, and their respiratory parameters and user evaluation of the VR-BRES were compared with conventional deep breathing (CDB) exercises. RESULTS: The respiratory parameters, forced vital capacity (Z = 4.82, 4.95, p < .001), forced expiratory volume in one second (t = 6.02, 6.26, p < .001), and peak expiratory flow (t = 5.35, 5.68, p < .001) were significantly higher during breathing exercises using the VR-BRES. User evaluation was also significantly higher for the VR-BRES in terms of efficiency (Z = 3.86, p < .001), entertainingness (Z = 5.00, p < .001), and intention to use (Z = 3.22, p = .001) compared to CDB. However, there was no difference in convenience between the two methods (Z = -0.90, p = .369). CONCLUSION: The VR-BRES has the potential to be an efficient breathing exercise solution. We recommend a clinical study that evaluates the effects of the VR-BRES for a certain period of time for people who need breathing exercises.


Subject(s)
Virtual Reality , Adult , Breathing Exercises , Cross-Over Studies , Feasibility Studies , Humans , Mouth
2.
Sci Rep ; 11(1): 24108, 2021 12 16.
Article in English | MEDLINE | ID: covidwho-1585796

ABSTRACT

Despite the great potential of Virtual Reality (VR) to arouse emotions, there are no VR affective databases available as it happens for pictures, videos, and sounds. In this paper, we describe the validation of ten affective interactive Virtual Environments (VEs) designed to be used in Virtual Reality. These environments are related to five emotions. The testing phase included using two different experimental setups to deliver the overall experience. The setup did not include any immersive VR technology, because of the ongoing COVID-19 pandemic, but the VEs were designed to run on stereoscopic visual displays. We collected measures related to the participants' emotional experience based on six discrete emotional categories plus neutrality and we included an assessment of the sense of presence related to the different experiences. The results showed how the scenarios can be differentiated according to the emotion aroused. Finally, the comparison between the two experimental setups demonstrated high reliability of the experience and strong adaptability of the scenarios to different contexts of use.


Subject(s)
Arousal/physiology , COVID-19/psychology , Databases, Factual/statistics & numerical data , Emotions/physiology , SARS-CoV-2/isolation & purification , Virtual Reality , Adult , COVID-19/epidemiology , COVID-19/virology , Emotions/classification , Empathy , Female , Humans , Male , Pandemics/prevention & control , Photic Stimulation/methods , Reproducibility of Results , SARS-CoV-2/physiology , Young Adult
3.
Medicine (Baltimore) ; 100(50): e27844, 2021 Dec 17.
Article in English | MEDLINE | ID: covidwho-1583963

ABSTRACT

INTRODUCTION: Due to the current COVID-19 pandemic, surgical training has become increasingly challenging due to required social distancing. Therefore, the use of virtual reality (VR)-simulation could be a helpful tool for imparting surgical skills, especially in minimally invasive environments. Visual spatial ability (VSA) might influence the learning curve for laparoscopic surgical skills. However, little is known about the influence of VSA for surgical novices on VR-simulator training regarding the complexity of different tasks over a long-term training period. Our study evaluated prior VSA and VSA development in surgical trainees during VR-simulator training, and its influence on surgical performance in simulator training. METHODS: In our single-center prospective two-arm randomized trial, VSA was measured with a tube figure test before curriculum training. After 1:1 randomization, the training group (TG) participated in the entire curriculum training consisting of 48 different VR-simulator tasks with varying difficulty over a continuous nine-day training session. The control group (CG) performed two of these tasks on day 1 and 9. Correlation and regression analyses were used to assess the influence of VSA on VR-related surgical skills and to measure procedural abilities. RESULTS: Sixty students (33 women) were included. Significant improvements in the TG in surgical performance and faster completion times were observed from days 1 to 9 for the scope orientation 30° right-handed (SOR), and cholecystectomy dissection tasks after the structured 9-day training program. After training, the TG with pre-existing low VSA scores achieved performance levels similar to those with pre-existing high VSA scores for the two VR simulator tasks. Significant correlations between VSA and surgical performance on complex laparoscopic camera navigation SOR tasks were found before training. CONCLUSIONS: Our study revealed that that all trainees improved their surgical skills irrespective of previous VSA during structured VR simulator training. An increase in VSA resulted in improvements in surgical performance and training progress, which was more distinct in complex simulator tasks. Further, we demonstrated a positive relationship between VSA and surgical performance of the TG, especially at the beginning of training. Our results identified pre-existing levels of VSA as a predictor of surgical performance.


Subject(s)
Clinical Competence , Laparoscopy , Simulation Training , Spatial Navigation , Virtual Reality , COVID-19 , Female , Humans , Laparoscopy/education , Pandemics , Prospective Studies , User-Computer Interface
4.
J Med Internet Res ; 23(2): e26292, 2021 02 22.
Article in English | MEDLINE | ID: covidwho-1574360

ABSTRACT

BACKGROUND: Chronic low back pain is the most prevalent chronic pain condition worldwide and access to behavioral pain treatment is limited. Virtual reality (VR) is an immersive technology that may provide effective behavioral therapeutics for chronic pain. OBJECTIVE: We aimed to conduct a double-blind, parallel-arm, single-cohort, remote, randomized placebo-controlled trial for a self-administered behavioral skills-based VR program in community-based individuals with self-reported chronic low back pain during the COVID-19 pandemic. METHODS: A national online convenience sample of individuals with self-reported nonmalignant low back pain with duration of 6 months or more and with average pain intensity of 4 or more/10 was enrolled and randomized 1:1 to 1 of 2 daily (56-day) VR programs: (1) EaseVRx (immersive pain relief skills VR program); or (2) Sham VR (2D nature content delivered in a VR headset). Objective device use data and self-reported data were collected. The primary outcomes were the between-group effect of EaseVRx versus Sham VR across time points, and the between-within interaction effect representing the change in average pain intensity and pain-related interference with activity, stress, mood, and sleep over time (baseline to end-of-treatment at day 56). Secondary outcomes were global impression of change and change in physical function, sleep disturbance, pain self-efficacy, pain catastrophizing, pain acceptance, pain medication use, and user satisfaction. Analytic methods included intention-to-treat and a mixed-model framework. RESULTS: The study sample was 179 adults (female: 76.5%, 137/179; Caucasian: 90.5%, 162/179; at least some college education: 91.1%, 163/179; mean age: 51.5 years [SD 13.1]; average pain intensity: 5/10 [SD 1.2]; back pain duration ≥5 years: 67%, 120/179). No group differences were found for any baseline variable or treatment engagement. User satisfaction ratings were higher for EaseVRx versus Sham VR (P<.001). For the between-groups factor, EaseVRx was superior to Sham VR for all primary outcomes (highest P value=.009), and between-groups Cohen d effect sizes ranged from 0.40 to 0.49, indicating superiority was moderately clinically meaningful. For EaseVRx, large pre-post effect sizes ranged from 1.17 to 1.3 and met moderate to substantial clinical importance for reduced pain intensity and pain-related interference with activity, mood, and stress. Between-group comparisons for Physical Function and Sleep Disturbance showed superiority for the EaseVRx group versus the Sham VR group (P=.022 and .013, respectively). Pain catastrophizing, pain self-efficacy, pain acceptance, prescription opioid use (morphine milligram equivalent) did not reach statistical significance for either group. Use of over-the-counter analgesic use was reduced for EaseVRx (P<.01) but not for Sham VR. CONCLUSIONS: EaseVRx had high user satisfaction and superior and clinically meaningful symptom reduction for average pain intensity and pain-related interference with activity, mood, and stress compared to sham VR. Additional research is needed to determine durability of treatment effects and to characterize mechanisms of treatment effects. Home-based VR may expand access to effective and on-demand nonpharmacologic treatment for chronic low back pain. TRIAL REGISTRATION: ClinicalTrials.gov NCT04415177; https://clinicaltrials.gov/ct2/show/NCT04415177. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/25291.


Subject(s)
COVID-19 , Chronic Pain/therapy , Health Behavior , Low Back Pain/therapy , Pain Management/methods , Virtual Reality , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Double-Blind Method , Female , Humans , Male , Middle Aged , Pandemics , Self Report , Time Factors , Young Adult
5.
Int J Radiat Oncol Biol Phys ; 111(1): 29-35, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1531476

ABSTRACT

PURPOSE: We describe the implementation of a novel virtual educational program for medical students, Radiation Oncology Virtual Education Rotation (ROVER), and its effect on student interest and knowledge in radiation oncology. METHODS AND MATERIALS: ROVER comprised a series of virtual educational panels with case-based discussions across disease sites tailored to medical students. The panels were moderated by radiation oncology residents and included faculty panelists from academic radiation oncology programs across the country. Student pre- and postsession surveys were collected. Paired t tests were used to compare the pre- and postsession assessment results. RESULTS: Six ROVER sessions were held from June 4, 2020, to August 20, 2020, with a total of 427 medical students registering for at least 1 session. Of these, 231 students attended at least 1 session, with 140 completing at least 1 postsession survey (60.6% response rate). Fourth-year medical students were the largest group represented among attendees (32.0%). Most attendees had exposure to radiation oncology (78.8%) before the sessions. The majority of students signed up for these sessions for education (90.6%). Some students signed up for the sessions to help with specialty selection (30.9%) and to network (30.4%). Medical students' understanding of the role of radiation oncology in each disease site (breast, sarcoma, central nervous system, pediatrics, gastrointestinal, genitourinary, gynecologic, lymphoma, lung, and head and neck) was improved by attending each session (pre- vs postsession; P < .0001 for all disease sites). Over three-quarters of respondents stated they were considering applying or were likely to apply to radiation oncology both before and after the sessions. CONCLUSIONS: ROVER improved medical student perceived knowledge of radiation oncology across all disease sites covered. ROVER fulfills a need for a national medical student education platform for radiation oncology. Future work is warranted to augment virtual and open educational platforms to improve access to radiation oncology education.


Subject(s)
Education, Medical , Radiation Oncology/education , Virtual Reality , Female , Humans , Male , Students, Medical
6.
J Alzheimers Dis ; 84(2): 883-893, 2021.
Article in English | MEDLINE | ID: covidwho-1518456

ABSTRACT

BACKGROUND: People with advanced dementia often exhibit responsive behaviors such as apathy, depression, agitation, aggression, and psychosis. Non-pharmacological approaches (e.g., listening to music, watching television, doing arts and crafts) are now considered as a first-line strategy to manage responsive behaviors in clinical practice due to the potential risks associated with the antipsychotic medications. To date, no evaluations of immersive non-head mounted virtual reality (VR) experience as a non-pharmacologic approach for people with advanced dementia living in nursing homes have been reported. OBJECTIVE: To evaluate the feasibility (acceptance and safety) of VR experience. METHODS: A single site case series (nonrandomized and unblinded) with a convenience sample (N = 24; age = 85.8±8.6 years; Cognitive Performance Scale score = 3.4±0.6) measuring depression and agitation before and after the intervention. The intervention was a 30-min long research coordinator- facilitated VR experience for two weeks (10 sessions). RESULTS: The intervention was feasible (attrition rate = 0% ; adverse events = 0). A reduction in depression and in agitation was observed after the intervention. However, we suggest extreme caution in interpreting this result considering the study design and small sample size. CONCLUSION: This study provides the basis for conducting a randomized controlled trial to evaluate the effect of VR experience on responsive behaviors in nursing homes. Since our intervention uses a smart remote-controlled projector without a headset, infectious exposure can be avoided following the COVID-19 pandemic-induced physical distancing policy in care homes.


Subject(s)
COVID-19/virology , Nursing Homes , SARS-CoV-2/pathogenicity , Virtual Reality , Aged , Aged, 80 and over , Aggression/psychology , Dementia/psychology , Female , Humans , Male , Quality of Life/psychology
7.
Rev Neurol ; 73(10): 345-350, 2021 Nov 16.
Article in Spanish | MEDLINE | ID: covidwho-1513474

ABSTRACT

INTRODUCTION: The health pandemic brought about by SARS-CoV-2 (COVID-19) has limited access to neurorehabilitation programmes for many patients who have suffered stroke, traumatic brain injury or acquired brain damage due to some other cause. As telerehabilitation allows for the provision of care in situations of social distancing, it may mitigate the negative effects of confinement. The aim of this study was to determine the efficacy, adherence and usability of a teleneurorehabilitation intervention for patients with acquired brain injury. PATIENTS AND METHODS: All patients included in a face-to-face neurorehabilitation programme at the time of the declaration of the state of alarm in Spain due to COVID-19 and who agreed to participate in the study were included in a teleneurorehabilitation programme. The effectiveness of the programme, understood as an improvement in independence, was quantified with the Barthel index. Adherence to the programme and usability of the tool were explored through questionnaires. RESULTS: Altogether, 46 patients, accounting for 70.6% of the total, participated in the study. Participants significantly improved their independence and showed an improvement in the Barthel index between the start (77.3 ± 28.6) and the end of the programme (82.3 ± 26). Adherence to the intervention was very high (8.1 ± 2.2 out of 10) and the online sessions were the most highly rated content. The tool used showed a high usability (50.1 ± 9.9 out of 60) and could be used without assistance by more than half the participants. CONCLUSION: The teleneurorehabilitation intervention was found to be effective in improving patients' independence, and promoted a high degree of adherence and usability.


Subject(s)
Brain Injuries/complications , Brain Injuries/rehabilitation , COVID-19/complications , Continuity of Patient Care/organization & administration , Telerehabilitation/organization & administration , Adult , Aged , Female , Humans , Male , Middle Aged , Pandemics , Patient Compliance , Patient Satisfaction , Physical Distancing , Program Evaluation , Spain/epidemiology , Surveys and Questionnaires/standards , Virtual Reality
8.
Acta odontol. Colomb. (En linea) ; 11(2): 116-126, 2021. ilus, ilus, tab
Article in Spanish | LILACS (Americas) | ID: covidwho-1498040

ABSTRACT

La continuidad de la formación del especialista de Ortodoncia, en tiempos de pandemia por la COVID-19, constituye todo un reto para los docentes. Por ello, este ensayo reflexiona y presenta, tomando como referencia el primer año de la mencionada especialidad (debido a su complejidad), la experiencia con la virtualización de la formación posgraduada durante este periodo en Santiago de Cuba. Durante esta experiencia, las alternativas que se han propuesto incluyen a las diferentes habilidades a desarrollar según formas de organización de la enseñanza, las cuales abarcan desde actividades (base de datos, foro, tarea), recursos virtuales (archivo, carpeta o tarea) hasta tipos de evaluación. En todas estas clases, a excepción de la Educación en el Trabajo, se implementó la modalidad de clase invertida. Finalmente, se consideró que esta modalidad se configuró como una alternativa para darle continuidad al proceso de enseñanza aprendizaje y favorecer la adquisición de habilidades de manera independiente y creadora.


Continuing the training of the Orthodontic specialist in times of a COVID-19 pandemic constitutes a challenge for teachers. For this reason, this essay reflects and presents, taking as a reference the first year of the aforementioned specialty (due to its complexity), the experience with the virtualization of postgraduate training during this period in Santiago de Cuba. During this experience, the alternatives that have been proposed include the different skills to be developed according to forms of teaching organization, which range from activities (database, forum, task), virtual resources (file, folder or task) to types of evaluation. In all these classes, with the exception of education at work, the inverted class modality was implemented. Finally, it was considered that this modality was configured as an alternative to give continuity to the teaching-learning process and favor the acquisition of skills in an independent and creative way.


Subject(s)
Humans , Orthodontics/education , COVID-19 , Teaching , Lecture , Education, Distance , Virtual Reality
9.
J Med Internet Res ; 23(9): e29210, 2021 09 20.
Article in English | MEDLINE | ID: covidwho-1484953

ABSTRACT

BACKGROUND: Apathy is a frequent and underrecognized neurological disorder symptom. Reduced goal-directed behavior caused by apathy is associated with poor outcomes for older adults in residential aged care. Recommended nonpharmacological treatments include person-centered therapy using information and communication technology. Virtual reality (VR) in the form of head-mounted displays (HMDs) is a fully immersive technology that provides access to a wide range of freely available content. The use of VR as a therapy tool has demonstrated promise in the treatment of posttraumatic stress disorder and anxiety. In addition, VR has been used to improve conditions including depression, anxiety, cognitive function, and balance in older adults with memory deficits, Alzheimer disease, and Parkinson disease. Research using VR for the symptoms of apathy in older adults living in residential aged care facilities is limited. OBJECTIVE: This study aims to examine whether using HMDs as a tool for reminiscence therapy improves the symptoms of apathy compared with using a laptop computer and physical items with older adults living in residential aged care. METHODS: In this multisite trial, 43 participants were allocated to one of three groups: reminiscence therapy intervention using VR in the form of HMDs, reminiscence therapy using a laptop computer supplemented by physical items if required (active control), and a usual care (passive control) group. The primary outcome was apathy, and the secondary outcomes included cognition and depression. The side effects of using HMDs were also measured in the VR group. RESULTS: Mixed model analyses revealed no significant group interaction over time in outcomes between the VR and laptop groups (estimate=-2.24, SE 1.89; t40=-1.18; P=.24). Pooled apathy scores in the two intervention groups compared with the passive control group also revealed no significant group interaction over time (estimate=-0.26, SE 1.66; t40=-0.16; P=.88). There were no significant secondary outcomes. Most participants in the VR group stated that they would prefer to watch content in VR than on a flat screen (Χ22=11.2; P=.004), side effects from HMD use were negligible to minimal according to the Simulator Sickness Questionnaire cutoff scores. CONCLUSIONS: Although there were no significant results in outcome measures, this study found that participants engaged in the research and enjoyed the process of reminiscing using both forms of technology. It was found that VR can be implemented in an aged care setting with correct protocols in place. Providing residents in aged care with a choice of technology may assist in increasing participation in activities. We cannot dismiss the importance of immediate effects while the therapy was in progress, and this is an avenue for future research. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619001510134; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378564. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-DOI: 10.1136/bmjopen-2020-046030.


Subject(s)
Apathy , Parkinson Disease , Virtual Reality , Aged , Australia , Cognition , Humans
10.
Radiat Oncol ; 16(1): 204, 2021 Oct 16.
Article in English | MEDLINE | ID: covidwho-1468071

ABSTRACT

BACKGROUND: The COVID-19 pandemic has stripped many medical students worldwide of their right to quality education. In response, we developed hybrid courses involving aspects of both online and in-person teaching for radiation oncology medical student clerkship. METHODS: We entitled students to customize their own rotation schedule using Google Forms and developed a flipped learning online class, which consisted of at least one video clip on basic knowledge of radiation oncology per day (yonsei-radonc.com). Students were instructed to watch online videos before the next day's discussion session. Required components of the medical education program (e.g., target drawing, site visits to treatment facilities) were also prepared and conducted in accordance with the appropriate level of social distancing measures. Finally, we conducted questionnaire surveys after the completion of the week-long course and clerkship. RESULTS: From March to June 2020, 110 fourth-year medical students undertook a clinical module in our 1-week radiation oncology program course. Each day, students completed the flipped learning prior to meeting with the educator and then participated in the online discussion session and conference. All activities were well performed as scheduled. Students' motivation was high, as was their overall satisfaction with the course. The students were satisfied with the online contents, flipped learning strategy, and instructors. CONCLUSIONS: We successfully integrated open and virtual educational platforms to improve access to and satisfaction with student clerkship. In the future "new normal," minimized face-to-face learning interactions, such as flipped learning, should be actively utilized for medical and other students' education.


Subject(s)
COVID-19/epidemiology , Education, Medical , Radiation Oncology/education , SARS-CoV-2 , Virtual Reality , Cross-Sectional Studies , Curriculum , Humans , Program Evaluation , Students, Medical , Teaching , Telemedicine
12.
Vaccine ; 39(46): 6746-6753, 2021 11 05.
Article in English | MEDLINE | ID: covidwho-1458732

ABSTRACT

Effective interventions for increasing people's intention to get vaccinated are crucial for global health, especially considering COVID-19. We devised a novel intervention using virtual reality (VR) consisting of a consultation with a general practitioner for communicating the benefits of COVID-19 vaccination and, in turn, increasing the intention to get vaccinated against COVID-19. We conducted a preregistered online experiment with a 2×2 between-participant design. People with eligible VR headsets were invited to install our experimental application and complete the ten minute virtual consultation study at their own discretion. Participants were randomly assigned across two age conditions (young or old self-body) and two communication conditions (with provision of personal benefit of vaccination only, or collective and personal benefit). The primary outcome was vaccination intention (score range 1-100) measured three times: immediately before and after the study, as well as one week later. Five-hundred-and-seven adults not vaccinated against COVID-19 were recruited. Among the 282 participants with imperfect vaccination intentions (<100), the VR intervention increased pre-to-post vaccination intentions across intervention conditions (mean difference 8.6, 95% CI 6.1 to 11.1,p<0.0001). The pre-to-post difference significantly correlated with the vaccination intention one week later, ρ=0.20,p<0.0001. The VR intervention was effective in increasing COVID-19 vaccination intentions both when only personal benefits and personal and collective benefits of vaccination were communicated, with significant retention one week after the intervention. Utilizing recent evidence from health psychology and embodiment research to develop immersive environments with customized and salient communication efforts could therefore be an effective tool to complement public health campaigns.


Subject(s)
COVID-19 , Virtual Reality Exposure Therapy , Virtual Reality , Adult , COVID-19 Vaccines , Humans , Intention , SARS-CoV-2 , Vaccination
13.
J Med Internet Res ; 23(2): e25322, 2021 02 15.
Article in English | MEDLINE | ID: covidwho-1456194

ABSTRACT

BACKGROUND: To provide participants with a more real and immersive intervening experience, virtual reality (VR) and/or augmented reality (AR) technologies have been integrated into some bystander intervention training programs and studies measuring bystander behaviors. OBJECTIVE: We focused on whether VR or AR can be used as a tool to enhance training bystanders. We reviewed the evidence from empirical studies that used VR and/or AR as a tool for examining bystander behaviors in the domain of interpersonal violence research. METHODS: Two librarians searched for articles in databases, including APA PsycInfo (Ovid), Criminal Justice Abstracts (EBSCO), Medline (Ovid), Applied Social Sciences Index & Abstracts (ProQuest), Sociological Abstracts (ProQuest), and Scopus till April 15, 2020. Studies focusing on bystander behaviors in conflict situations were included. All study types (except reviews) written in English in any discipline were included. RESULTS: The search resulted in 12,972 articles from six databases, and the articles were imported into Covidence. Eleven studies met the inclusion and exclusion criteria. All 11 articles examined the use of VR as a tool for studying bystander behaviors. Most of the studies were conducted in US young adults. The types of interpersonal violence were school bullying, dating violence, sexual violence/assault, and soccer-associated violence. VR technology was used as an observational measure and bystander intervention program. We evaluated the different uses of VR for bystander behaviors and noted a lack of empirical evidence for AR as a tool. We also discuss the empirical evidence regarding the design, effectiveness, and limitations of implementing VR as a tool in the reviewed studies. CONCLUSIONS: The reviewed results have implications and recommendations for future research in designing and implementing VR/AR technology in the area of interpersonal violence. Future studies in this area may further contribute to the use of VR as an observational measure and explore the potential use of AR to study bystander behaviors.


Subject(s)
Augmented Reality , Bystander Effect/physiology , Interpersonal Psychotherapy/methods , Violence/psychology , Virtual Reality , Female , Humans , Male
14.
Ann Med ; 53(1): 1520-1530, 2021 12.
Article in English | MEDLINE | ID: covidwho-1455001

ABSTRACT

OBJECTIVE: During the COVID-19 pandemic, emergency medicine (EM) teachers had to employ innovative methods to ensure the continuity of the education process. The purpose of this study was to explore the adequacy of the 360-degree video (video 360) technology in EM education in the context of: (a) students' attitudes towards the video 360; (b) students' academic performance in their required examination at the end of the EM course compared to the assessment results of students from the previous academic year. METHODS: A mixed-method research project enrolled the fourth-year medical students who attended the required EM course during the first semester of the academic year 2020-2021 when all activities with undergraduate students went online and teaching scenarios recorded in the video 360 format were employed. Data collection was two-fold: (a) anonymous questionnaires, complemented with basic YouTube analytics; (b) multiple-choice questionnaires (MCQ) and oral examination, contrasting the results with those in 2019-2020. Data analysis used descriptive statistics and non-parametric methods. RESULTS: Seventy-nine students (53 females and 26 males) participated in the project and all completed the EM course. Students' interest in and their acceptance of the video 360 technology were high (total scoring in the upper 20% of the respective scales), with consistently good performance in two parallel, independent, interview-based oral/practical evaluations (Spearman correlation coefficient R = 0.665, p < .001). The majority scored over 90% in the summative MCQ, with higher values compared to their colleagues' during the previous academic year (with on-site teaching): scoring percentages with mean ± standard deviation of 92.52 ± 4.57 and 76.67 ± 18.77, respectively. CONCLUSION: Our project showed that the video 360 scenarios were effective in teaching EM. In the long term, employing this accessible and inexpensive educational approach would add value to on-site training by enriching the exposure to a specific ED environment.KEY MESSAGESMedical students valued the 360-degree video scenarios as contributing substantially to their EM knowledge and preparedness.Examination results confirmed the 360-degree video scenarios as viable in EM teaching.The 360-degree video technology would be a sustainable solution for hybrid medical teaching in the long term.


Subject(s)
COVID-19/epidemiology , Education, Medical, Undergraduate/methods , Emergency Medicine/education , Students, Medical/statistics & numerical data , Virtual Reality , Educational Measurement , Female , Humans , Male
15.
Orv Hetil ; 162(40): 1591-1600, 2021 10 03.
Article in Hungarian | MEDLINE | ID: covidwho-1448615

ABSTRACT

Összefoglaló. Bevezetés: A COVID-19-pandémia okozta nagyfokú betegszám-növekedés ellátásának érdekében az egészségügyi rendszerek gyakran a kórházak teljes átszervezésére kényszerültek. A szakállomány gyors és hatékony felzárkóztatása kulcsfontosságú ilyen körülmények között. A telepített kórházi egységek személyzetének felkészítésére a virtuális valóságban levezetheto csoportos gyakorlatozás ígéretes módszernek mutatkozik. Célkituzés: Célunk egy telepített kórház személyzetének felkészítésére alkalmazott virtuális szimulációs gyakorlatsorozat tapasztalatainak bemutatása, valamint a létrehozott és kipróbált virtuális gyakorlatcsomagok adaptálási lehetoségeinek elméleti bemutatása a COVID-19-kórházak személyzetének gyors felzárkóztatását szolgáló gyakorlatsorozat lehetséges kivitelezése érdekében. Módszer: Három, prototípusként eloállított virtuális gyakorlat került alkalmazásba két próbatanfolyam keretén belül. A virtuális színterek kialakítására az XVR szimulációs szoftvert használtuk. A gyakorlatok alkalmazhatóságának és hasznosságának kiértékelésére anonim kérdoíves felméréseket készítettünk. Az adatok feldolgozásában kereszttábla-elemzést és khi-négyzet-próbát alkalmaztunk. Eredmények: A két próbaképzésen nyolc ország képviseletében összesen 76 gyakornok vett részt. A résztvevok 63,9%-a szerint a módszer alkalmas ilyen jellegu gyakorlatok levezetésére, de további fejlesztéseket igényel. Véleményük, hogy technikai használata "elég könnyen" elsajátítható (59,7%), és interaktív (90,32%), valósághu (45,0%) szimulációs közeget biztosít. Megbeszélés: Eredményeink alapján a virtuális valóság egy alkalmazható módszer a telepített kórházak szakállományának valós bevetésekre való felkészítésére. A létrehozott virtuális gyakorlatcsomagok tartalma és szerkezete könnyen adaptálható egy COVID-19 ideiglenes egészségügyi egység sajátos munkakörülményeihez való gyors személyzeti felzárkóztatást szolgáló muhelygyakorlatok megszervezéséhez. Következtetés: A virtuális valóság ígéretes oktatási eszköz, amely kiegészítheti a nagy költségekkel és bonyolult szervezéssel járó terepgyakorlatokat, megközelítve azok oktatási hatásfokát. A virtuális térben megélt tapasztalatok valós szakmai élményekké alakulnak, és hozzájárulnak egy biztonságos és hatékony munkaközeg gyors kialakításához. Orv Hetil. 2021; 162(40): 1591-1600. INTRODUCTION: COVID-19 pandemic imposed sudden increase in hospital admissions, thus medical systems needed to reorganize entire hospitals quite often. Quick and efficient training is of outmost importance. Virtual reality team training is a promising tool for newly organized hospital units' staff. OBJECTIVE: Our goal was to present the usefulness and applicability of virtual simulation exercises for training of field hospital personnel and to evaluate the adaptability of these created and tested exercise packs for urgent staff training of COVID-19 hospitals. METHOD: Three prototypes of virtual reality exercises were assessed through two test courses. XVR simulation software was used to create virtual environments. Evaluation of exercise applicability and utility was performed by anonymous questionnaires. Statistical data-processing was performed using contingency table and chi-square tests. RESULTS: 76 trainees from eight countries participated in the two pilot courses. 63.9% of the participants stated that the method is suitable for conducting such exercises, but needs further development. Its technical use is "easy enough" to learn (59.7%) and provides an interactive (90.32%) and realistic (45.0%) working environment. DISCUSSION: Virtual reality is applicable to train field hospital staffs for real missions. The created virtual exercise packages are easily adaptable, both in content and structure, to workshops dedicated for quick training of specific COVID-19 temporary medical facility's personnel. CONCLUSION: Virtual reality is a promising educational tool that can complement the expensive and laborious field exercises, with comparable training efficiency. These virtual reality experiences may become real professional memories and create swiftly a secure and efficient professional milieu. Orv Hetil. 2021; 160(40): 1591-1600.


Subject(s)
COVID-19 , Virtual Reality , Hospitals , Humans , Hungary , Mobile Health Units , Pandemics , SARS-CoV-2
16.
J Med Internet Res ; 23(9): e26623, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1443943

ABSTRACT

BACKGROUND: Prior studies have shown that virtual reality (VR) is an efficacious treatment modality for opioid-sparing pain management. However, the majority of these studies were conducted among primarily White, relatively advantaged populations and in well-resourced settings. OBJECTIVE: We conducted a qualitative, theory-informed implementation science study to assess the readiness for VR in safety-net settings. METHODS: Using the theoretical lens of the Consolidated Framework for Implementation Research (CFIR) framework, we conducted semistructured interviews with current VR users and nonusers based in safety-net health systems (n=15). We investigated barriers and facilitators to a commercially available, previously validated VR technology platform AppliedVR (Los Angeles, CA, USA). We used deductive qualitative analysis using the overarching domains of the CFIR framework and performed open, inductive coding to identify specific themes within each domain. RESULTS: Interviewees deemed the VR intervention to be useful, scalable, and an appealing alternative to existing pain management approaches. Both users and nonusers identified a lack of reimbursement for VR as a significant challenge for adoption. Current users cited positive patient feedback, but safety-net stakeholders voiced concern that existing VR content may not be relevant or appealing to diverse patients. All respondents acknowledged the challenge of integrating and maintaining VR in current pain management workflows across a range of clinical settings, and this adoption challenge was particularly acute, given resource and staffing constraints in safety-net settings. CONCLUSIONS: VR for pain management holds interest for frontline pain management clinicians and leadership in safety-net health settings but will require significant tailoring and adaption to address the needs of diverse populations. Integration into complex workflows for pain management is a significant barrier to adoption, and participants cited structural cost and reimbursement concerns as impediments to initial implementation and scaling of VR use.


Subject(s)
Virtual Reality , Analgesics, Opioid , Humans , Implementation Science , Pain Management
17.
BMJ Open ; 11(9): e049704, 2021 09 28.
Article in English | MEDLINE | ID: covidwho-1443600

ABSTRACT

INTRODUCTION: Intensive care unit (ICU) admission of a relative might lead to psychological distress and complicated grief (post-intensive care syndrome-family; PICS-F). Evidence suggests that increased distress during ICU stay increases risk of PICS-F, resulting in difficulty returning to their normal lives after the ICU experience. Effective interventions to improve PICS-F are currently lacking. In the present trial, we hypothesised that information provision using ICU-specific Virtual Reality for Family members/relatives (ICU-VR-F) may improve understanding of the ICU and subsequently improve psychological well-being and quality of life in relatives of patients admitted to the ICU. METHODS AND ANALYSIS: This multicentre, clustered randomised controlled trial will be conducted from January to December 2021 in the mixed medical-surgical ICUs of four hospitals in Rotterdam, the Netherlands. We aim to include adult relatives of 160 ICU patients with an expected ICU length of stay over 72 hours. Participants will be randomised clustered per patient in a 1:1 ratio to either the intervention or control group. Participants allocated to the intervention group will receive ICU-VR-F, an information video that can be watched in VR, while the control group will receive usual care. Initiation of ICU-VR-F will be during their hospital visit unless participants cannot visit the hospital due to COVID-19 regulations, then VR can be watched digitally at home. The primary objective is to study the effect of ICU-VR-F on psychological well-being and quality of life up to 6 months after the patients' ICU discharge. The secondary outcome is the degree of understanding of ICU treatment and ICU modalities. ETHICS AND DISSEMINATION: The Medical Ethics Committee of the Erasmus Medical Centre, Rotterdam, the Netherlands, approved the study and local approval was obtained from each participating centre (NL73670.078.20). Our findings will be disseminated by presentation of the results at (inter)national conferences and publication in scientific, peer-reviewed journals. TRIAL REGISTRATION NUMBER: Netherlands Trial Register (TrialRegister.nl, NL9220).


Subject(s)
COVID-19 , Virtual Reality , Adult , Critical Illness , Humans , Intensive Care Units , Multicenter Studies as Topic , Quality of Life , Randomized Controlled Trials as Topic , SARS-CoV-2
18.
Integr Cancer Ther ; 20: 15347354211049341, 2021.
Article in English | MEDLINE | ID: covidwho-1440882
19.
Hu Li Za Zhi ; 68(5): 13-17, 2021 Oct.
Article in Chinese | MEDLINE | ID: covidwho-1436328

ABSTRACT

Technology developments change education strategies. Incorporating virtual reality into lesson plans allows education to focus not only on learning knowledge but also on knowledge and skills integration. In simulation education, learning environments are designed to approximate actual clinical situations, allowing students to practice skills in virtual clinical situations continuously. In addition, clinical lecturers may observe the students' practice process and provide feedback. Furthermore, through experiencing and practicing clinical procedures, students gain critical clinical judgment, skills, and teamwork operation competences, which may be applied in the real world. In Taiwan, the majority of nurse practitioner training is implemented in hospitals, and clinical training is done using hands-on and face-to-face teaching strategies within a mentorship framework. Because of the ongoing COVID-19 pandemic, this hospital-based training model has been significantly challenged. However, this represents an opportunity to migrate the nurse practitioner training model toward technology-based simulation education. Developing more virtual-reality-based lesson plans centered on clinical situations may help students complete training that is normally conducted in hospital teaching environments. Through repetitive practice in virtual reality settings, students may obtain comprehensive knowledge and clinical skills that will help relieve the subsequent stress of clinical practicum work and promote care quality and patient safety.


Subject(s)
COVID-19 , Nurse Practitioners , Simulation Training , Virtual Reality , Clinical Competence , Humans , Pandemics , SARS-CoV-2
20.
BMJ Open ; 11(9): e048611, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1435049

ABSTRACT

OBJECTIVE: To develop a virtual reality simulation training programme, and further verify the effect of the programme on improving the response capacity of emergency reserve nurses confronting public health emergencies. DESIGN: A prospective quasiexperimental design with a control group. PARTICIPANTS: A total of 120 nurses were recruited and randomly divided into the control group and the intervention group. INTERVENTION: Participants underwent a 3-month training. The control group received the conventional training of emergency response (eg, theoretical lectures, technical skills and psychological training), while the intervention group underwent the virtual reality simulation training in combination with skills training. The COVID-19 cases were incorporated into the intervention group training, and the psychological training was identical to both groups. At the end of the training, each group conducted emergency drills twice. Before and after the intervention, the two groups were assessed for the knowledge and technical skills regarding responses to fulminate respiratory infectious diseases, as well as the capacity of emergency care. Furthermore, their pandemic preparedness was assessed with a disaster preparedness questionnaire. RESULTS: After the intervention, the scores of the relevant knowledge, the capacity of emergency care and disaster preparedness in the intervention group significantly increased (p<0.01). The score of technical skills in the control group increased more significantly than that of the intervention group (p<0.01). No significant difference was identified in the scores of postdisaster management in two groups (p>0.05). CONCLUSION: The virtual reality simulation training in combination with technical skills training can improve the response capacity of emergency reserve nurses as compared with the conventional training. The findings of the study provide some evidence for the emergency training of reserve nurses in better response to public health emergencies and suggest this methodology is worthy of further research and popularisation.


Subject(s)
COVID-19 , Nurses, Public Health , Simulation Training , Virtual Reality , China , Clinical Competence , Emergencies , Humans , Prospective Studies , Public Health , SARS-CoV-2
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