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Technical problems with VR scenario development
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The goal of this single-center, prospective, randomized, controlled trial is to evaluate the effectiveness of using virtual reality technology to provide learners with skills and knowledge in the management of traumatic cardiac arrest in first-year residents at the emergency department.
The main question it aims to answer is:
Does the use of virtual reality in the context of trauma cardiopulmonary resuscitation training result in shorter times to order/perform pre-defined critical actions?
Participants will learn management skills for in-hospital traumatic cardiac arrest using either newly developed virtual reality software or e-learning focused on the same content.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| e-learning | Other |
| |
| Virtual reality training | Other |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| e-learning | Other | Participants will complete an e-learning course over a two-week period that focuses on skills and knowledge related to the management of in-hospital cardiac arrest. This course prepares participants for an in-person assessment. |
| Measure | Description | Time Frame |
|---|---|---|
| Time to critical action | Expert-based assessment of the difference in time (seconds) to the predefined primary critical action between randomized groups in video recordings of an in-person assessment simulation. | evaluation within 4 weeks after study completion |
| Measure | Description | Time Frame |
|---|---|---|
| Time to secondary critical action #1 | Expert-based assessment of the difference in time (seconds) to the predefined secondary critical action #1 between randomized groups in video recordings of an in-person assessment simulation. | evaluation within 4 weeks after study completion |
| Time to secondary critical action #2 |
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Inclusion Criteria:
Exclusion Criteria:
- pre-disposition for cybersickness (motion sickness, pregnancy, pre-existing cybersickness)
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medical University of Vienna | Vienna | 1090 | Austria |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39854477 | Derived | Lintschinger JM, Metelka P, Kapral L, Kahlfuss F, Reischmann L, Kaider A, Holaubek C, Kaiser G, Wagner M, Ettl F, Sixt L, Schaden E, Hafner C. Enhancing trauma cardiopulmonary resuscitation simulation training with the use of virtual reality (Trauma SimVR): Protocol for a randomized controlled trial. PLoS One. 2025 Jan 24;20(1):e0316828. doi: 10.1371/journal.pone.0316828. eCollection 2025. |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| Virtual reality training | Other | Participants will complete a virtual reality training over a two-week period that focuses on skills and knowledge related to the management of in-hospital cardiac arrest. This training prepares participants for an in-person assessment. |
|
Expert-based assessment of the difference in time (seconds) to the predefined secondary critical action #2 between randomized groups in video recordings of an in-person assessment simulation. |
| evaluation within 4 weeks after study completion |
| Number of unrecognized causes of traumatic cardiac arrest | Expert-based assessment of the difference in unrecognized underlying causes of traumatic cardiac arrest between randomized groups in video recordings of an in-person assessment simulation. | evaluation within 4 weeks after study completion |
| Number of patients declared dead prematurely | Expert-based assessment of the difference in the number of patients declared dead prematurely between the randomized groups in video recordings of an in-person assessment simulation. | evaluation within 4 weeks after study completion |
| Number of protocol deviations | Expert-based assessment of the difference in the frequency of protocol deviations between randomized groups in video recordings of an in-person assessment simulation. Protocol deviations are listed in the study protocol and reflect the recommendations of the guidelines on which the study is based. | evaluation within 4 weeks after study completion |
| Gender-differences in learning outcomes | Expert-based assessment of the difference in time (seconds) to the predefined primary critical action between randomized groups in video recordings of an in-person assessment simulation based on gender. | evaluation within 4 weeks after study completion |
| Group difference in global cognitive load while performing the in-person assessment simulation | Assessment of the difference in global cognitive load between randomized groups immediately following the in-person assessment simulation using the National Aeronautics and Space Administration (NASA) global task load index, which ranges from 0 to 100. Higher scores indicate greater cognitive load. | evaluation within 4 weeks after study completion |
| Group difference in cognitive load (per objective) while performing the in-person assessment simulation | Assessment of the difference in cognitive load (per objective) between randomized groups immediately following the in-person assessment simulation using the National Aeronautics and Space Administration (NASA) task load index, which ranges from 0 to 100. Objectives are: (mental demand, physical demand, temporal demand, performance, effort, frustration). Higher scores indicate greater mental demand/higher physical demand/ higher temporal demand/worse performance/more effort/more frustration). | evaluation within 4 weeks after study completion |
| Gaze behavior during the in-person assessment simulation: dwell-time in areas of interest | Assessment of differences (in seconds) in gaze behavior (dwell time in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor. | evaluation within 4 weeks after study completion |
| Gaze behavior during the in-person assessment simulation: fixation count in areas of interest | Assessment of differences in gaze behavior (fixation count in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation. The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor. | evaluation within 4 weeks after study completion |
| Gaze behavior during the in-person assessment simulation: average fixation duration in areas of interest | Assessment of differences (in seconds) in gaze behavior (average fixation duration in areas of interest) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interest for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor. | evaluation within 4 weeks after study completion |
| Gaze behavior during the in-person assessment simulation: time when no area of interest is illustrated | Assessment of differences (in seconds) in gaze behavior (time when no area of interest is illustrated) using Tobii Pro eye-tracking technology between randomized groups based on recordings of the in-person assessment simulation The defined areas of interst for analysis are the manikin's head/airway, the manikin's thorax, the vital signs monitor, and the ventilator monitor. | evaluation within 4 weeks after study completion |
| Participants' subjective impressions of their learning progress when using virtual reality/e-learning | 5-point Likert scale 1 - not helpful at all; 2 - rather not helpful; 3 - neither helpful nor not helpful; 4 - rather helpful; 5 - very helpful | evaluation within 4 weeks after study completion |
| Participants' subjective impressions of their level of frustration when using virtual reality/e-learning | 5-point Likert scale 1 - not frustrated at all; 2 - rather not frustrated; 3 - neither frustrated nor not frustrated; 4 - rather frustrated; 5 - very frustrated | evaluation within 4 weeks after study completion |
| Participants' subjective impression of their level of enjoyment when using virtual reality/e-learning | 5-point Likert scale 1 - not enjoyed at all; 2 - rather not enjoyed; 3 - neither enjoyed nor not enjoyed; 4 - rather enjoyed; 5 - very enjoyed | evaluation within 4 weeks after study completion |
| Participants' subjective confidence in recognizing and providing initial care to polytraumatized patients in cardiac arrest in the in-person assessment simulation | 5-point Likert scale 1 - not confident at all; 2 - rather not confident; 3 - neither confident nor not confident; 4 - rather confident; 5 - very confident | evaluation within 4 weeks after study completion |
| Participants' subjective overall performance in the simulation sessions | 5-point Likert scale 1 - not good at all; 2 - rather not good; 3 - neither good nor not good; 4 - rather good; 5 - very good | evaluation within 4 weeks after study completion |
| Participants' overall performance in the simulation sessions from the expert's point of view | 5-point Likert scale 1 - not good at all; 2 - rather not good; 3 - neither good nor not good; 4 - rather good; 5 - very good | evaluation within 4 weeks after study completion |
| The correlation between how often participants have played virtual reality video games in the past 12 months and the primary outcome | Spearman correlation Frequency of playing within the past 12 months: never; less than once a week; once per week; more than once per week; daily | evaluation within 4 weeks after study completion |
| The correlation between how often participants have played virtual reality video games between the ages of 6 and 18 and the primary outcome | Spearman correlation Frequency of playing at the age of 6 to 18: never; less than once a week; once per week; more than once per week; daily | evaluation within 4 weeks after study completion |
| The correlation between how often participants have played non-virtual-reality video games in the past 12 months and the primary outcome | Spearman correlation Frequency of playing within the past 12 months: never; less than once a week; once per week; more than once per week; daily | evaluation within 4 weeks after study completion |
| The correlation between how often participants have played non-virtual-reality video games between the ages of 6 and 18 and the primary outcome | Spearman correlation Frequency of playing at the age of 6 to 18: never; less than once a week; once per week; more than once per week; daily | evaluation within 4 weeks after study completion |
| Incidence rate of virtual reality related adverse events | Incidence of nausea, vomiting, dizziness, headache, overexertion/fatigue of the eyes (discomfort, blurred vision), stumbling, falling, bumping into real world objects while using virtual reality | evaluation within 4 weeks after study completion |
| System usability score for use of VR simulations | System Usability Scale score from 1 to 100 points | evaluation within 4 weeks after study completion |
| Adjective Rating Scale for the use of the virtual reality simulations | 7-point Likert scale 1 - the worst thing you can imagine; 2 - terrible; 3 - poor; 4 - okay; 5 - good; 6 - excellent; 7 - the best thing you can imagine | evaluation within 4 weeks after study completion |