scholarly journals Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study

10.2196/17425 ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. e17425
Author(s):  
Daniel Katz ◽  
Ronak Shah ◽  
Elizabeth Kim ◽  
Chang Park ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Life Support ◽  
Survival Rates ◽  
Cost Effective ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Team Leader ◽  
Cost Comparison

Background The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. Objective This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. Methods This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. Results A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; P<.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); P<.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. Conclusions Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.

scholarly journals Utilization of a Voice-Based Virtual Reality Advanced Cardiac Life Support Team Leader Refresher: Prospective Observational Study (Preprint)

2019 ◽  
Author(s):  
Daniel Katz ◽  
Ronak Shah ◽  
Elizabeth Kim ◽  
Chang Park ◽  
Anjan Shah ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Life Support ◽  
Survival Rates ◽  
Cost Effective ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Team Leader ◽  
Cost Comparison

BACKGROUND The incidence of cardiac arrests per year in the United States continues to increase, yet in-hospital cardiac arrest survival rates significantly vary between hospitals. Current methods of training are expensive, time consuming, and difficult to scale, which necessitates improvements in advanced cardiac life support (ACLS) training. Virtual reality (VR) has been proposed as an alternative or adjunct to high-fidelity simulation (HFS) in several environments. No evaluations to date have explored the ability of a VR program to examine both technical and behavioral skills and demonstrate a cost comparison. OBJECTIVE This study aimed to explore the utility of a voice-based VR ACLS team leader refresher as compared with HFS. METHODS This prospective observational study performed at an academic institution consisted of 25 postgraduate year 2 residents. Participants were randomized to HFS or VR training and then crossed groups after a 2-week washout. Participants were graded on technical and nontechnical skills. Participants also completed self-assessments about the modules. Proctors were assessed for fatigue and task saturation, and cost analysis based on local economic data was performed. RESULTS A total of 23 of 25 participants were included in the scoring analysis. Fewer participants were familiar with VR compared with HFS (9/25, 36% vs 25/25, 100%; <i>P</i>&lt;.001). Self-reported satisfaction and utilization scores were similar; however, significantly more participants felt HFS provided better feedback: 99 (IQR 89-100) vs 79 (IQR 71-88); <i>P</i>&lt;.001. Technical scores were higher in the HFS group; however, nontechnical scores for decision making and communication were not significantly different between modalities. VR sessions were 21 (IQR 19-24) min shorter than HFS sessions, the National Aeronautics and Space Administration task load index scores for proctors were lower in each category, and VR sessions were estimated to be US $103.68 less expensive in a single-learner, single-session model. CONCLUSIONS Utilization of a VR-based team leader refresher for ACLS skills is comparable with HFS in several areas, including learner satisfaction. The VR module was more cost-effective and was easier to proctor; however, HFS was better at delivering feedback to participants. Optimal education strategies likely contain elements of both modalities. Further studies are needed to examine the utility of VR-based environments at scale.

A prospective, observational study of Xigris Use in the United States (XEUS)

2010 ◽  
Vol 25 (4) ◽  
pp. 660.e9-660.e16 ◽  
Author(s):  
Jay S. Steingrub ◽  
Michael L. Cheatham ◽  
Brad Woodward ◽  
H. Tiffany Wang ◽  
Mark B. Effron
Keyword(s):  
United States ◽  
Observational Study ◽  
Prospective Observational Study ◽  
The United States

Sentinel node biopsy versus elective neck dissection. Which is more cost-effective? A prospective observational study

2016 ◽  
Vol 44 (5) ◽  
pp. 550-556 ◽  
Author(s):  
Josué Hernando ◽  
Pedro Villarreal ◽  
Francisco Álvarez-Marcos ◽  
Luís García-Consuegra ◽  
Lorena Gallego ◽  
...  
Keyword(s):  
Observational Study ◽  
Sentinel Node ◽  
Neck Dissection ◽  
Sentinel Node Biopsy ◽  
Prospective Observational Study ◽  
Cost Effective ◽  
Elective Neck Dissection ◽  
Node Biopsy

scholarly journals Exploring User Needs in the Development of a Virtual Reality–Based Advanced Life Support Training Platform: Exploratory Usability Study

10.2196/20797 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e20797
Author(s):  
Nathan Moore ◽  
Soojeong Yoo ◽  
Philip Poronnik ◽  
Martin Brown ◽  
Naseem Ahmadpour
Keyword(s):  
Virtual Reality ◽  
Life Support ◽  
Advanced Life Support ◽  
Cost Effective ◽  
User Needs ◽  
Training Tool ◽  
Future Design ◽  
Advanced Roles ◽  
Vr Training ◽  
Future Work

Background Traditional methods of delivering Advanced Life Support (ALS) training and reaccreditation are resource-intensive and costly. Interactive simulations and gameplay using virtual reality (VR) technology can complement traditional training processes as a cost-effective, engaging, and flexible training tool. Objective This exploratory study aimed to determine the specific user needs of clinicians engaging with a new interactive VR ALS simulation (ALS-SimVR) application to inform the ongoing development of such training platforms. Methods Semistructured interviews were conducted with experienced clinicians (n=10, median age=40.9 years) following a single playthrough of the application. All clinicians have been directly involved in the delivery of ALS training in both clinical and educational settings (median years of ALS experience=12.4; all had minimal or no VR experience). Interviews were supplemented with an assessment of usability (using heuristic evaluation) and presence. Results The ALS-SimVR training app was well received. Thematic analysis of the interviews revealed five main areas of user needs that can inform future design efforts for creating engaging VR training apps: affordances, agency, diverse input modalities, mental models, and advanced roles. Conclusions This study was conducted to identify the needs of clinicians engaging with ALS-SimVR. However, our findings revealed broader design considerations that will be crucial in guiding future work in this area. Although aligning the training scenarios with accepted teaching algorithms is important, our findings reveal that improving user experience and engagement requires careful attention to technology-specific issues such as input modalities.

scholarly journals The Value of Focused Echocardiography During Cardiac Arrest

2019 ◽  
Vol 35 (6) ◽  
pp. 484-490
Author(s):  
Julie White
Keyword(s):  
Cardiac Arrest ◽  
Life Support ◽  
Medical Condition ◽  
Advanced Cardiac Life Support ◽  
The United States ◽  
Area Of Interest ◽  
Palpable Pulse ◽  
Life Threatening ◽  
Developing Area ◽  
Focused Echocardiography

Cardiac arrest is the absence of a centrally palpable pulse and no respiratory effort in an unresponsive patient. This often-lethal medical condition affects hundreds of thousands of people in the United States alone every year. Immediate intervention is crucial to provide the patient with any chance of survival. Advanced cardiac life support (ACLS) is the cornerstone therapy for cardiac arrest. Increased awareness and proper identification of life-threatening arrhythmias is critical, as it may lead to prompt medical treatment and improved mortality. The use of focused echocardiography, during a cardiac arrest, has been a developing area of interest over the past several years. The specific aim of this literature review was to emphasize the role of a focused echocardiogram and the valuable information that can be provided during a cardiac arrest.

scholarly journals Brief interventions for obesity when patients are asked to pay for weight loss treatment: an observational study in primary care with an embedded randomised trial

2020 ◽  
Vol 70 (694) ◽  
pp. e348-e355 ◽  
Author(s):  
Kate Tudor ◽  
Susan A Jebb ◽  
Indrani Manoharan ◽  
Paul Aveyard
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Observational Study ◽  
Brief Intervention ◽  
Randomised Trial ◽  
Cost Effective ◽  
Cost Comparison ◽  
West Midlands ◽  
Weight Loss Programme ◽  
The Cost

BackgroundA brief intervention whereby GPs opportunistically facilitate an NHS-funded referral to a weight loss programme is clinically and cost-effective.AimTo test the acceptability of a brief intervention and attendance at a weight loss programme when GPs facilitate a referral that requires patients to pay for the service.Design and settingAn observational study of the effect of a GP encouraging attendance at a weight loss programme requiring self-payment in the West Midlands from 16 October 2018 to 30 November 2018, to compare with a previous trial in England in which the service was NHS-funded.MethodSixty patients with obesity who consecutively attended primary care appointments received an opportunistic brief intervention by a GP to endorse and offer a referral to a weight loss programme at the patient’s own expense. Participants were randomised to GPs who either stated the weekly monetary cost of the programme (basic cost) or who compared the weekly cost to an everyday discretionary item (cost comparison). Participants were subsequently asked to report whether they had attended a weight loss programme.ResultsOverall, 47% of participants (n = 28) accepted the referral; 50% (n = 15) in the basic cost group and 43% (n = 13) in the cost comparison group. This was significantly less than in a previous study when the programme was NHS-funded (77%, n = 722/940; P<0.0001). Most participants reported the intervention to be helpful/very helpful and appropriate/very appropriate (78%, n = 46/59 and 85%, n = 50/59, respectively) but scores were significantly lower than when the programme was NHS-funded (92% n = 851/922 and 88% n = 813/922, respectively; P = 0.004). One person (2%) attended the weight loss programme, which is significantly lower than the 40% of participants who attended when the programme was NHS-funded (P<0.0001).ConclusionGP referral to a weight loss programme that requires patients to pay rather than offering an NHS-funded programme is acceptable; however, it results in almost no attendance.

Abstract 461: Evaluation of the Impact of Additional Structured Cardiac Arrest Training on Internal Medicine Residents in a Community Hospital

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Abdullah Zoheb Azhar ◽  
Monil Majmundar ◽  
Shmuel Golfeyz ◽  
Tikal Kansara ◽  
Jonna Mercado ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Cardiac Arrest ◽  
Community Hospital ◽  
Life Support ◽  
Statistical Significance ◽  
Advanced Cardiac Life Support ◽  
Hospital Staff ◽  
The United States ◽  
Bivariate Analysis ◽  
The Impact

Introduction: There are approximately 200,000 cases of in-hospital cardiac arrest (IHCA) annually in the United States. Of these cases, only 40-50% achieve return of spontaneous circulation (ROSC) and only 20-30% are discharged. Though most hospital staff are trained in cardiac arrest resuscitation, a significant disparity in resuscitation has been noted between different hospital settings. We thus instituted additional structured cardiac arrest training in an Internal Medicine residency program, to supplement the biennial advanced cardiac life support (ACLS) training. Hypothesis: We hypothesized that institution of a dedicated structured cardiac arrest team (code team) in addition to monthly training for those on the team, would improve the confidence, skills, and leadership level, of residents at managing an IHCA situation. Methods: A structured code team with specific roles for each resident was instituted in a New York City-based community hospital. Training was guided by audio-visual lectures and then reinforced by performing mock cardiac arrest drills. Resident assessments were done pre and post-training through an anonymous standardized questionnaire. Summative measures of mean confidence, mean ACLS skills, and leadership were evaluated. Uni and bivariate analysis, and T-tests for statistical significance were performed using STATA 15 software. Results: Our sample of 32 residents showed an increase in mean learning scores across all the three domains. Confidence scores increased from 7.23 to 8.44, ACLS skills increased from 7.40 to 8.57 and leadership scores increased from 6.56 to 7.88. Paired T-tests demonstrated high significance (P<0.000). Conclusion: This study demonstrates the effectiveness of additional structured cardiac arrest training on confidence, skills, and leadership of resident physicians in an Internal Medicine program. The next phase of this study will be to re-evaluate knowledge and confidence at 3 and 6 months after training.

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