This randomized controlled pilot trial evaluated the feasibility and effectiveness of immersive virtual reality (VR)-based pediatric emergency training in 24 healthcare professionals (12 interprofessional dyads). Participants were randomized to receive either facilitator-guided debriefing or self-guided debriefing following VR training. The primary outcome was feasibility, with secondary outcomes including teamwork performance, ABCDE adherence, and perceived debriefing effectiveness.
VR training significantly improved teamwork performance (facilitator-guided: mean improvement 1.2, CI 0.5 to 1.9, p=0.005; self-guided: mean improvement 1.4, CI 0.8 to 2.0, p<0.001) and ABCDE adherence (both groups: mean improvement 0.5, facilitator-guided CI 0.1 to 1.0, p=0.02; self-guided CI 0.1 to 0.9, p=0.01). While performance outcomes were similar between debriefing methods, participants perceived facilitator-guided debriefing as more effective (mean difference 1.4, CI 0.1 to 2.7, p=0.04).
Regarding safety, 46% of participants reported some cybersickness, though VR was generally acceptable and usable. Two participants did not complete the intervention, and two did not complete follow-up. Key limitations include the pilot study design, small sample size of 24 participants, and substantial logistical coordination requirements. Funding and conflicts of interest were not reported.
This pilot suggests VR-based pediatric emergency training is feasible and may improve interprofessional performance. The comparable outcomes between self-guided and facilitator-guided debriefing highlight potential for scalable implementation, though larger trials are needed to formally evaluate non-inferiority. Clinicians should interpret these findings as preliminary evidence requiring confirmation in adequately powered studies.
View Original Abstract ↓
UNLABELLED: This study evaluated the feasibility and effectiveness of immersive virtual reality (VR)-based paediatric emergency training, comparing facilitator-guided with self-guided debriefing methods. In a single-blinded, randomised controlled pilot trial, 24 healthcare professionals (12 interprofessional dyads) were randomised to VR-based paediatric emergency training followed by either facilitator- or self-guided debriefing. Both groups received a standardised preparatory lecture and skills workshop. We collected data on the feasibility of the interventions and additional trial procedures. For pre- and post-performance assessment, all dyads were video-recorded whilst managing a mannequin-based paediatric emergency. Two independent, blinded raters assessed the dyads' teamwork, ABCDE adherence, and time to critical actions based on the videos. We also collected data on participants' cognitive load and perceived effectiveness of the two debriefing methods. The study demonstrated the feasibility of interprofessional VR-based paediatric emergency training with both facilitator- and self-guided debriefing in a clinical setting. Twenty-two healthcare professionals completed the intervention, and 20 completed follow-up. VR was acceptable and usable, though 46% of participants reported some cybersickness. Additional trial procedures were feasible but required substantial logistical coordination. VR training significantly improved teamwork (facilitator-guided mean 1.2, confidence interval (CI) 0.5 to 1.9, p = 0.005; self-guided mean 1.4, CI 0.8 to 2.0, p < 0.001) and ABCDE adherence (facilitator-guided mean 0.5, CI 0.1 to 1.0, p = 0.02; self-guided mean 0.5, CI 0.1 to 0.9, p = 0.01), with similar outcomes between the debriefing methods. However, participants perceived the facilitator-guided debriefing to be more effective (mean difference 1.4, CI 0.1 to 2.7, p = 0.04).
CONCLUSION: Immersive VR-based paediatric emergency training with facilitator-guided and self-guided debriefing was feasible in a pilot context and yielded comparable performance outcomes. A larger, adequately powered trial is warranted to formally evaluate non-inferiority between debriefing methods.
WHAT IS KNOWN: • Simulation-based paediatric emergency training improves clinical outcomes, but widespread implementation is limited by logistical challenges and high costs. • Immersive virtual reality (VR) may help overcome these barriers, yet evidence on its feasibility and effectiveness in this context is limited.
WHAT IS NEW: • VR-based paediatric emergency training is feasible and effectively improves interprofessional performance. • Self-guided and facilitator-guided debriefing yielded comparable outcomes, highlighting the potential for scalable use.
