Remote 360 virtual simulation-can you 'do sim' completely online?

ABSTRACT

Background Simulation is resource heavy in terms of time, space, equipment, and faculty, with limitations on the number of people you can deliver each session to. During the COVID-19 pandemic, social distancing makes face to face simulation more challenging. After working with a local healthcare VR team through a return to training project1, we explored benefits and acceptability of remotely debriefing 360° videos of simulated paediatric emergencies. Remote debrief has been used successfully in the past to train teams2 and faculty3. However, it's use in the context of 360 content is still novel. The theory being that because the participant is an 'active observer' this would bring a more immersive experience. Objectives We were keen to assess whether this novel method of experiencing simulation teaching was engaging, immersive and safe. Methods Using 360° content filmed at Royal Devon and Exeter hospitals, we ran a remote virtual simulation session over MS Teams video conferencing platform in local and regional paediatric teaching sessions. After a quick but vital pre-brief we asked the learners to watch a pre-filmed scenario (www.youtube.com/watch? v=1SqvH6TA-Kw). We guided them to interact with the video, directing their view in the 360° media to whatever interested them. This was followed by a debrief using a modified 'standard' simulation debrief structure. We collected feedback on its acceptability and similarity to face to face simulation. Results Between April 2020- March 2020. 9 Sessions around 130 learners, 60 gave feedback. Sessions were embedded in local, regional (South west) and international (Wales) teaching. Group sizes ranged from 6 to 40 learners. Levels ranged from medical students, foundation doctors, trainees and Paediatric consultants. Sessions were accessed on phones or computers at work or home. Feedback was globally positive 100% 'would do it again'. Qualitative feedback was rich and promising . 'more life-like than expected' . 'safer than real sim as I didn't feel judged' . '360 element meant you had a different perspective'. Interestingly for some sessions we had more senior grade learners than our usual simulation sessions - this directed debriefs towards the non-technical learning which was discussed more than the medical learning. The debrief often led to learners sharing stories of clinical encounters and it did not seem to matter that they did not actively participate in the simulation. Additional positives include . Easy accessibility for anyone to view 360 video (no need beyond normal consumer technology). . No need for additional faculty or manikins. . Relatively quick and engaging to run remotely. . Larger groups can be engage (and fit in a room) than standard simulation. After presenting this work in 2020, other hospitals have taken our pre-made scenarios and have used them for their own virtual sessions. Conclusions We recommend remote 360 sim with debrief as a fantastic adjunct to standard simulation. The modality is low cost, well received and a safe method of providing people with an experience of emergency scenarios. This is enhanced though a supportive debrief. The experiences have helped establish some 'best practices' for this evolving modality, which we are keen to share.