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The objective of this study is to assess the effects of virtual reality instructional design on physical therapy students' clinical decision-making skills, as compared with a traditional method of instruction with the same content and duration of exposure.
An online random number generator will be used to randomize students into one of two groups: virtual reality instruction or role-paying instruction. All students will complete self-reported measures of clinical decision-making and metacognitive awareness prior to receiving their allocated instruction. While completing allocated instruction (either virtual reality or role-playing), measures of diagnostic accuracy and diagnostic efficiency will be collected. Following virtual reality or role-playing instruction, all included subjects will complete post-test measures of clinical decision-making ,metacognitive awareness, and engagement. One week later, all included subjects will be assessed on a musculoskeletal objective structured clinical examination (mOSCE).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Virtual reality instructional design | Experimental | Completion of virtual reality simulation of an outpatient physical therapy evaluation. |
|
| Role-playing instructional design | Active Comparator | Completion of traditional role-playing of a scripted outpatient physical therapy evaluation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual reality instructional design | Other | 60 minute immersive VR experience with branching method information delivery, physical therapy assessment, and diagnosis. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in clinical decision-making | The Clinical Decision-Making Tool (CDM-Tool), a Likert-style questionnaire with 12 items, scored on a four-point scale. A higher raw score indicates a higher level of perceived decision-making ability. | pre- and post-instructional design (immediately after completing virtual reality or role-playing) |
| Measure | Description | Time Frame |
|---|---|---|
| Change in metacognitive awareness | Metacognitive Awareness Inventory (MAI), a Likert-style questionnaire with 52-items, scored on a five-point scale. A higher raw score indicates a higher level of perceived metacognitive awareness. | pre and post-instructional design (immediately after completing virtual reality or role-playing) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Patti Berg-Poppe, PT, PhD | University of South Dakota | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Shenandoah University | Winchester | Virginia | 22601 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26577020 | Background | Kleinert R, Heiermann N, Plum PS, Wahba R, Chang DH, Maus M, Chon SH, Hoelscher AH, Stippel DL. Web-Based Immersive Virtual Patient Simulators: Positive Effect on Clinical Reasoning in Medical Education. J Med Internet Res. 2015 Nov 17;17(11):e263. doi: 10.2196/jmir.5035. | |
| 30204773 | Background | Middeke A, Anders S, Schuelper M, Raupach T, Schuelper N. Training of clinical reasoning with a Serious Game versus small-group problem-based learning: A prospective study. PLoS One. 2018 Sep 11;13(9):e0203851. doi: 10.1371/journal.pone.0203851. eCollection 2018. |
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| Role-playing instructional design | Other | 60 minute traditional role-playing with standardized patient |
|
| Self-reported measure of engagement |
Six-item, five-point Likert-style instrument. A higher raw score indicates greater level of student engagement. |
| Post-instruction (immediately after completing either virtual reality or role-playing experience) |
| Objective Structured Clinical Examination (OSCE) | Practical examination with 2 cases, assessing a student's ability to generate hypotheses, perform tests or measures to rule-in or rule-out hypotheses, and deliver an appropriate intervention. | 1 week following allocated instruction (either virtual reality or role-playing) |
| 32044851 | Background | Middeke A, Anders S, Raupach T, Schuelper N. Transfer of Clinical Reasoning Trained With a Serious Game to Comparable Clinical Problems: A Prospective Randomized Study. Simul Healthc. 2020 Apr;15(2):75-81. doi: 10.1097/SIH.0000000000000407. |