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

2020 ◽  
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 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 A Workplace-Based Observation Strategy to Assess Prehospital Care Delivery by Public Ambulances in Ukraine

2019 ◽  
Vol 34 (s1) ◽  
pp. s179-s180
Author(s):  
Stanislav Gaievskyi ◽  
Oleksandr Linchevskyy ◽  
Colin Meghoo
Keyword(s):  
Life Support ◽  
Care Delivery ◽  
Prehospital Care ◽  
Advanced Life Support ◽  
Cost Effective ◽  
Financial Resources ◽  
Successful Implementation ◽  
Patient Privacy ◽  
Patient Encounter ◽  
Treatment Protocols

Introduction:Current methods to evaluate the delivery of urgent prehospital care often rely on inadequate surrogate measures or unreliable self-reported data. A workplace-based strategy may be feasible to assess the delivery of prehospital care by ambulances in selected populations.Aim:To perform a nationwide assessment of the psychomotor performance of public ambulance workers in Ukraine, we created a plan of workplace-based observation. We conducted a post-hoc analysis of this strategy to assess feasibility, strengths, and limitations for future use in assessing prehospital ambulance performance.Methods:With support from the Ministry of Health, we sent teams of trained observers to 30 ambulance substations across Ukraine. Using data collection tools on mobile devices, these observers accompanied Advanced Life Support ambulances on urgent calls for periods of 72 hours. We evaluated this program for collecting patient encounter data against the investment of time, personnel, and financial resources.Results:Over a two-month period, we directly observed 524 patient encounters by public ambulances responding to urgent calls at 30 ambulance substations across Ukraine. We employed 6 observers and 2 administrators over this time period. Collecting our observations required 2,160 person-hours at the ambulance substations. The total distance traveled to these sites was 11,375 kilometers. Project costs amounted to 37,000 USD, equating to 71 USD per observed patient encounter.Discussion:Workplace-based assessments are a cost-effective strategy to collect data on the delivery of prehospital care in select populations. This data can be useful for identifying the current state of EMS care delivered and evaluating compliance with established treatment protocols. Successful implementation depends on effective planning and coordination with a commitment of time, personnel, and financial resources. Issues of patient privacy, legal permission, and observer training must be considered.

Real Handball Goalkeeper vs. Virtual Handball Thrower

2003 ◽  
Vol 12 (4) ◽  
pp. 411-421 ◽  
Author(s):  
Benoit Bideau ◽  
Richard Kulpa ◽  
Stéphane Ménardais ◽  
Laetitia Fradet ◽  
Franck Multon ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Virtual Environment ◽  
Motion Capture ◽  
Military Training ◽  
Human Motion ◽  
Virtual Experiment ◽  
Pilot Experiment ◽  
The Real ◽  
Training Tool ◽  
Future Work

Virtual reality offers new tools for human motion understanding. Several applications have been widely used in teleoperation, military training, driving and flying simulators, and so forth. We propose to test if virtual reality is a valid training tool for the game of handball. We focused on the duel between a handball goalkeeper and a thrower. To this end, we defined a pilot experiment divided into two steps: an experiment with real subjects and another one with virtual throwers. The throwers' motions were captured in order to animate their avatar in a reality center. In this paper, we focused on the evaluation of presence when a goalkeeper is confronting these avatars. To this end, we compared the goalkeeper's gestures in the real and in the virtual experiment to determine if virtual reality engendered the same movements for the same throw. Our results show that gestures did not differ between the real and virtual environment. As a consequence, we can say that the virtual environment offered enough realism to initiate natural gestures. Moreover, as in real games, we observed the goalkeeper's anticipation to allow us to use virtual reality in future work as a way to understand the goalkeeper and thrower interactions. The main originality of this work was to measure presence in a sporting application with new evaluation methods based on motion capture.

Cost-Effectiveness and Benefit of Alternatives to Improve Training for Prehospital Trauma Care in Mexico

2004 ◽  
Vol 19 (04) ◽  
pp. 318-325 ◽  
Author(s):  
Carlos Arreola-Risa ◽  
Charles Mock ◽  
Alejandro J. Herrera-Escamilla ◽  
Ismael Contreras ◽  
Jorge Vargas
Keyword(s):  
Latin America ◽  
Respiratory Distress ◽  
Trauma Care ◽  
Life Support ◽  
Advanced Life Support ◽  
Cost Effective ◽  
Advanced Cardiac Life Support ◽  
Control Site ◽  
San Pedro ◽  
Prehospital Trauma Care

AbstractIntroduction:In Latin America, there is a preponderance of prehospital trauma deaths. However, scarce resources mandate that any improvements in prehospital medical care must be cost-effective. This study sought to evaluate the costeffectiveness of several approaches to improving training for personnel in three ambulance services in Mexico.Methods:In Monterrey, training was augmented with PreHospital Trauma Life Support (PHTLS) at a cost of [US]$150 per medic trained. In San Pedro, training was augmented with Basic Trauma Life Support (BTLS), Advanced Cardiac Life Support (ACLS), and a locally designed airway management course, at a cost of $400 per medic. Process and outcome of trauma care were assessed before and after the training of these medics and at a control site.Results:The training was effective for both intervention services, with increases in basic airway maneuvers for patients in respiratory distress in Monterrey (16% before versus 39% after) and San Pedro (14% versus 64%). The role of endotrachal intubation for patients with respiratory distress increased only in San Pedro (5% versus 46%), in which the most intensive Advanced Life Support (ALS) training had been provided. However, mortality decreased only in Monterrey, where it had been the highest (8.2% before versus 4.7% after) and where the simplest and lowest cost interventions were implemented. There was no change in process or outcome in the control site.Conclusions:This study highlights the importance of assuring uniform, basic training for all prehospital providers. This is a more cost-effective approach than is higher-cost ALS training for improving prehospital trauma care in environments such as Latin America.

ALS-SimVR: Advanced Life Support Virtual Reality Training Application

2019 ◽  
Author(s):  
Nathan Moore ◽  
Soojeong Yoo ◽  
Naseem Ahmadpour ◽  
Russel Tommy ◽  
Martin Brown ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Life Support ◽  
Advanced Life Support ◽  
Virtual Reality Training

scholarly journals Cost-effectiveness of advanced life support and prehospital critical care for out-of-hospital cardiac arrest in England: a decision analysis model

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028574
Author(s):  
Johannes von Vopelius-Feldt ◽  
Jane Powell ◽  
Jonathan Richard Benger
Keyword(s):  
Cardiac Arrest ◽  
Critical Care ◽  
Cost Effectiveness ◽  
Life Support ◽  
Advanced Life Support ◽  
Cost Effective ◽  
Ambulance Service ◽  
Sensitivity Analyses ◽  
Decision Analysis Model ◽  
Hospital Cardiac Arrest

ObjectivesThis research aimed to answer the following questions: What are the costs of prehospital advanced life support (ALS) and prehospital critical care for out-of-hospital cardiac arrest (OHCA)? What is the cost-effectiveness of prehospital ALS? What improvement in survival rates from OHCA would prehospital critical care need to achieve in order to be cost-effective?SettingA single National Health Service ambulance service and a charity-funded prehospital critical care service in England.ParticipantsThe patient population is adult, non-traumatic OHCA.MethodsWe combined data from previously published research with data provided by a regional ambulance service and air ambulance charity to create a decision tree model, coupled with a Markov model, of costs and outcomes following OHCA. We compared no treatment for OHCA to the current standard of care of prehospital ALS, and prehospital ALS to prehospital critical care. To reflect the uncertainty in the underlying data, we used probabilistic and two-way sensitivity analyses.ResultsCosts of prehospital ALS and prehospital critical care were £347 and £1711 per patient, respectively. When costs and outcomes of prehospital, in-hospital and postdischarge phase of OHCA care were combined, prehospital ALS was estimated to be cost-effective at £11 407/quality-adjusted life year. In order to be cost-effective in addition to ALS, prehospital critical care for OHCA would need to achieve a minimally economically important difference (MEID) in survival to hospital discharge of 3%–5%.ConclusionThis is the first economic analysis to address the question of cost-effectiveness of prehospital critical care following OHCA. While costs of either prehospital ALS and/or critical care per patient with OHCA are relatively low, significant costs are incurred during hospital treatment and after discharge in patients who survive. Knowledge of the MEID for prehospital critical care can guide future research in this field.Trial registration numberISRCTN18375201

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.

scholarly journals Assessing expertise using eye tracking in a Virtual Reality flight simulation

2022 ◽  
Author(s):  
David Harris ◽  
Tom Arthur ◽  
Toby de Burgh ◽  
Mike Duxbury ◽  
Ross Lockett-Kirk ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Eye Movements ◽  
Eye Tracking ◽  
Real World ◽  
Eye Gaze ◽  
Cost Effective ◽  
Flight Simulation ◽  
Training Tool ◽  
Gaze Patterns ◽  
Scaling Analyses

Objective: The aim of this work was to examine the fidelity and validity of an aviation simulation using eye tracking. Background: Commercial head-mounted virtual reality (VR) systems offer a convenient and cost-effective alternative to existing aviation simulation (e.g., for refresher exercises). We performed pre-implementation testing of a novel aviation simulation, designed for head-mounted VR, to determine its fidelity and validity as a training device. Method: Eighteen airline pilots, with varying levels of flight experience, completed a sequence of training ‘flows’. Self-reported measures of presence and workload and users’ perceptions of fidelity were taken. Pilots’ eye movements and performance were recorded to determine whether more experienced pilots showed distinct performance and eye gaze profiles in the simulation, as they would in the real-world. Results: Real-world expertise correlated with eye gaze patterns characterised by fewer, but longer, fixations and a scan path that was more structured and less random. Multidimensional scaling analyses also indicated differential clustering of strategies in more versus less experienced pilots. Subjective ratings of performance, however, showed little relationship with real-world expertise or eye movements. Conclusion: We adopted an evidence-based approach to assessing the fidelity and validity of a VR flight training tool. Pilot reports indicated the simulation was realistic and potentially useful for training, while direct measurement of eye movements was useful for establishing construct validity and psychological fidelity of the simulation.

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