Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis

Jonathan R Abbas; Michael M H Chu; Ceyon Jeyarajah; Rachel Isba; Antony Payton; Brendan McGrath; Neil Tolley; Iain Bruce

doi:10.1016/j.resplu.2023.100484

Virtual reality in simulation-based emergency skills training: A systematic review with a narrative synthesis

Resusc Plus. 2023 Oct 21:16:100484. doi: 10.1016/j.resplu.2023.100484. eCollection 2023 Dec.

Authors

Jonathan R Abbas^{1

2}, Michael M H Chu², Ceyon Jeyarajah², Rachel Isba^{2

3

4}, Antony Payton^{1

5}, Brendan McGrath^{2

6}, Neil Tolley⁷, Iain Bruce^{1

2}

Affiliations

¹ The University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom.
² Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom.
³ Lancaster Medical School, Lancaster University, Lancaster LA1 4YW, United Kingdom.
⁴ Alder Hey Children's NHS Foundation Trust, Eaton Road Liverpool, L12 2AP, United Kingdom.
⁵ VREvo Ltd, The University of Manchester Core Technology Facility, 46 Grafton Street, Manchester, M13 9NT.
⁶ Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, United Kingdom.
⁷ Imperial College Healthcare NHS Trust, The Bays, South Wharf Road, St Mary's Hospital, London W2 1NY, United Kingdom.

Abstract

Objective: An important role is predicted for virtual reality (VR) in the future of medical education. We performed a systematic review of the literature with a narrative synthesis, to examine the current evidence for VR in simulation-based emergency skills training. We broadly define emergency skills as any clinical skill used in the emergency care of patients across all clinical settings.

Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. The data sources accessed during this study included: PubMed, CINAHL, EMBASE, AMED, EMCARE, HMIC, BNI, PsychINFO, Medline, CENTRAL, SCOPUS, Web of Science, BIOSIS Citation Index, ERIC, ACM Digital Library, IEEE Xplore, and ProQuest Dissertations and Thesis Global. Cochrane's Rob 2 and ROBVIS tools were used during study quality assessment. No ethical review was required for this work.

Results: Thirty-four articles published between 14th March 1998 and 1st March 2022 were included in this review. Studies were predominantly conducted in the USA and Europe and focussed on a variety of healthcare disciplines including medical, nursing, and allied health. VR education was delivered using head-mounted displays, Cave Automatic Virtual Environment systems, and bespoke setups. These systems delivered education in a variety of areas (emergency medicine, equipment training, obstetrics, and basic/advanced life support). Subjective potential advantages of this technology included realism, replayability, and time-effectiveness. Reports of adverse events were low in frequency across the included studies. Whilst clear educational benefit was generally noted, this was not reflected in changes to patient-based outcomes.

Conclusion: There may be educational benefit to using VR in the context of simulation-based emergency skills training including knowledge gain and retention, skill performance, acceptability, usability, and validity. Currently, there is insufficient evidence to demonstrate clear cost-effectiveness, or direct improvement of patient or institutional outcomes, at this stage.

Keywords: Emergency Simulation; Simulation; Systematic Review; Virtual Reality.

Publication types

Review