The goal of this single-center, prospective, randomized, controlled trial is to evaluate the effectiveness of using virtual reality technology to provide learners with skills and knowledge in the management of traumatic cardiac arrest in first-year residents at the emergency department. The main question it aims to answer is: Does the use of virtual reality in the context of trauma cardiopulmonary resuscitation training result in shorter times to order/perform pre-defined critical actions? Participants will learn management skills for in-hospital traumatic cardiac arrest using either newly developed virtual reality software or e-learning focused on the same content.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Participants will complete an e-learning course over a two-week period that focuses on skills and knowledge related to the management of in-hospital cardiac arrest. This course prepares participants for an in-person assessment.
Participants will complete a virtual reality training over a two-week period that focuses on skills and knowledge related to the management of in-hospital cardiac arrest. This training prepares participants for an in-person assessment.
Medical University of Vienna
Vienna, Austria
Time to critical action
Expert-based assessment of the difference in time (seconds) to the predefined primary critical action between randomized groups in video recordings of an in-person assessment simulation.
Time frame: evaluation within 4 weeks after study completion
Time to secondary critical action #1
Expert-based assessment of the difference in time (seconds) to the predefined secondary critical action #1 between randomized groups in video recordings of an in-person assessment simulation.
Time frame: evaluation within 4 weeks after study completion
Time to secondary critical action #2
Expert-based assessment of the difference in time (seconds) to the predefined secondary critical action #2 between randomized groups in video recordings of an in-person assessment simulation.
Time frame: evaluation within 4 weeks after study completion
Number of unrecognized causes of traumatic cardiac arrest
Expert-based assessment of the difference in unrecognized underlying causes of traumatic cardiac arrest between randomized groups in video recordings of an in-person assessment simulation.
Time frame: evaluation within 4 weeks after study completion
Number of patients declared dead prematurely
Expert-based assessment of the difference in the number of patients declared dead prematurely between the randomized groups in video recordings of an in-person assessment simulation.
Time frame: evaluation within 4 weeks after study completion
Number of protocol deviations
Expert-based assessment of the difference in the frequency of protocol deviations between randomized groups in video recordings of an in-person assessment simulation. Protocol deviations are listed in the study protocol and reflect the recommendations of the guidelines on which the study is based.
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Time frame: evaluation within 4 weeks after study completion
Gender-differences in learning outcomes
Expert-based assessment of the difference in time (seconds) to the predefined primary critical action between randomized groups in video recordings of an in-person assessment simulation based on gender.
Time frame: evaluation within 4 weeks after study completion
Group difference in global cognitive load while performing the in-person assessment simulation
Assessment of the difference in global cognitive load between randomized groups immediately following the in-person assessment simulation using the National Aeronautics and Space Administration (NASA) global task load index, which ranges from 0 to 100. Higher scores indicate greater cognitive load.
Time frame: evaluation within 4 weeks after study completion
Group difference in cognitive load (per objective) while performing the in-person assessment simulation
Assessment of the difference in cognitive load (per objective) between randomized groups immediately following the in-person assessment simulation using the National Aeronautics and Space Administration (NASA) task load index, which ranges from 0 to 100. Objectives are: (mental demand, physical demand, temporal demand, performance, effort, frustration). Higher scores indicate greater mental demand/higher physical demand/ higher temporal demand/worse performance/more effort/more frustration).
Time frame: evaluation within 4 weeks after study completion
Gaze behavior during the in-person assessment simulation: dwell-time in areas of interest
Assessment of differences (in seconds) in gaze behavior (dwell time in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor.
Time frame: evaluation within 4 weeks after study completion
Gaze behavior during the in-person assessment simulation: fixation count in areas of interest
Assessment of differences in gaze behavior (fixation count in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation. The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor.
Time frame: evaluation within 4 weeks after study completion
Gaze behavior during the in-person assessment simulation: average fixation duration in areas of interest
Assessment of differences (in seconds) in gaze behavior (average fixation duration in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor.
Time frame: evaluation within 4 weeks after study completion
Gaze behavior during the in-person assessment simulation: time when no area of interest is illustrated
Assessment of differences (in seconds) in gaze behavior (time when no area of interest is illustrated) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interst for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor.
Time frame: evaluation within 4 weeks after study completion
Participants' subjective impressions of their learning progress when using virtual reality/e-learning
5-point Likert scale 1 - not helpful at all; 2 - rather not helpful; 3 - neither helpful nor not helpful; 4 - rather helpful; 5 - very helpful
Time frame: evaluation within 4 weeks after study completion
Participants' subjective impressions of their level of frustration when using virtual reality/e-learning
5-point Likert scale 1 - not frustrated at all; 2 - rather not frustrated; 3 - neither frustrated nor not frustrated; 4 - rather frustrated; 5 - very frustrated
Time frame: evaluation within 4 weeks after study completion
Participants' subjective impression of their level of enjoyment when using virtual reality/e-learning
5-point Likert scale 1 - not enjoyed at all; 2 - rather not enjoyed; 3 - neither enjoyed nor not enjoyed; 4 - rather enjoyed; 5 - very enjoyed
Time frame: evaluation within 4 weeks after study completion
Participants' subjective confidence in recognizing and providing initial care to polytraumatized patients in cardiac arrest in the in-person assessment simulation
5-point Likert scale 1 - not confident at all; 2 - rather not confident; 3 - neither confident nor not confident; 4 - rather confident; 5 - very confident
Time frame: evaluation within 4 weeks after study completion
Participants' subjective overall performance in the simulation sessions
5-point Likert scale 1 - not good at all; 2 - rather not good; 3 - neither good nor not good; 4 - rather good; 5 - very good
Time frame: evaluation within 4 weeks after study completion
Participants' overall performance in the simulation sessions from the expert's point of view
5-point Likert scale 1 - not good at all; 2 - rather not good; 3 - neither good nor not good; 4 - rather good; 5 - very good
Time frame: evaluation within 4 weeks after study completion
The correlation between how often participants have played virtual reality video games in the past 12 months and the primary outcome
Spearman correlation Frequency of playing within the past 12 months: never; less than once a week; once per week; more than once per week; daily
Time frame: evaluation within 4 weeks after study completion
The correlation between how often participants have played virtual reality video games between the ages of 6 and 18 and the primary outcome
Spearman correlation Frequency of playing at the age of 6 to 18: never; less than once a week; once per week; more than once per week; daily
Time frame: evaluation within 4 weeks after study completion
The correlation between how often participants have played non-virtual-reality video games in the past 12 months and the primary outcome
Spearman correlation Frequency of playing within the past 12 months: never; less than once a week; once per week; more than once per week; daily
Time frame: evaluation within 4 weeks after study completion
The correlation between how often participants have played non-virtual-reality video games between the ages of 6 and 18 and the primary outcome
Spearman correlation Frequency of playing at the age of 6 to 18: never; less than once a week; once per week; more than once per week; daily
Time frame: evaluation within 4 weeks after study completion
Incidence rate of virtual reality related adverse events
Incidence of nausea, vomiting, dizziness, headache, overexertion/fatigue of the eyes (discomfort, blurred vision), stumbling, falling, bumping into real world objects while using virtual reality
Time frame: evaluation within 4 weeks after study completion
System usability score for use of VR simulations
System Usability Scale score from 1 to 100 points
Time frame: evaluation within 4 weeks after study completion
Adjective Rating Scale for the use of the virtual reality simulations
7-point Likert scale 1 - the worst thing you can imagine; 2 - terrible; 3 - poor; 4 - okay; 5 - good; 6 - excellent; 7 - the best thing you can imagine
Time frame: evaluation within 4 weeks after study completion