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Original article
peer-reviewed

Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation



Abstract

Introduction: Team training for procedural sedation for pediatric residents has traditionally consisted of didactic presentations and simulated scenarios using high-fidelity mannequins. We assessed the effectiveness of a virtual reality module in teaching preparation for and management of sedation for procedures.

Methods: After developing a virtual reality environment in Second Life® (Linden Lab, San Francisco, CA) where providers perform and recover patients from procedural sedation, we conducted a randomized controlled trial to assess the effectiveness of the virtual reality module versus a traditional web-based educational module. A 20 question pre- and post-test was administered to assess knowledge change. All subjects participated in a simulated pediatric procedural sedation scenario that was video recorded for review and assessed using a 32-point checklist. A brief survey elicited feedback on the virtual reality module and the simulation scenario.

Results: The median score on the assessment checklist was 75% for the intervention group and 70% for the control group (P = 0.32). For the knowledge tests, there was no statistically significant difference between the groups (P = 0.14). Users had excellent reviews of the virtual reality module and reported that the module added to their education.

Conclusions: Pediatric residents performed similarly in simulation and on a knowledge test after a virtual reality module compared with a traditional web-based module on procedural sedation. Although users enjoyed the virtual reality experience, these results question the value virtual reality adds in improving the performance of trainees. Further inquiry is needed into how virtual reality provides true value in simulation-based education.



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Original article
peer-reviewed

Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation


Author Information

Pavan P. Zaveri Corresponding Author

Division of Emergency Medicine, Children's National Health System

Aisha B. Davis

Division of Hospital Medicine, Children's National Health System

Karen J. O'Connell

Division of Emergency Medicine, Children's National Health System

Emily Willner

Division of Emergency Medicine, Children's National Health System

Dana A. Aronson Schinasi

Division of Emergency Medicine, Lurie Children's Hospital

Mary Ottolini

Division of Hospital Medicine, Children's National Health System


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Children's National Health System issued approval Pro00001633. This study was deemed exempt by the Institutional Review Board. As an educational study, the only link to the participant would be the name on the consent form, so written informed consent was waived. An information sheet was provided to each participant prior to participating in the study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

Acknowledgements

The authors thank Eileen Searson and Maria Lewis for their assistance in data management, Todd P. Chang, MD, MAcM for his assistance in module development, and Paul Santoro and Terrell Chandler of SRA International for their collaboration in developing the virtual reality module. The development of the virtual reality module was supported by a grant from the Children’s National Board of Visitors.


Original article
peer-reviewed

Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation


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Original article
peer-reviewed

Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation

  • Author Information
    Pavan P. Zaveri Corresponding Author

    Division of Emergency Medicine, Children's National Health System

    Aisha B. Davis

    Division of Hospital Medicine, Children's National Health System

    Karen J. O'Connell

    Division of Emergency Medicine, Children's National Health System

    Emily Willner

    Division of Emergency Medicine, Children's National Health System

    Dana A. Aronson Schinasi

    Division of Emergency Medicine, Lurie Children's Hospital

    Mary Ottolini

    Division of Hospital Medicine, Children's National Health System


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Children's National Health System issued approval Pro00001633. This study was deemed exempt by the Institutional Review Board. As an educational study, the only link to the participant would be the name on the consent form, so written informed consent was waived. An information sheet was provided to each participant prior to participating in the study. Animal subjects: This study did not involve animal subjects or tissue. Conflicts of interest: The authors have declared that no conflicts of interest exist.

    Acknowledgements

    The authors thank Eileen Searson and Maria Lewis for their assistance in data management, Todd P. Chang, MD, MAcM for his assistance in module development, and Paul Santoro and Terrell Chandler of SRA International for their collaboration in developing the virtual reality module. The development of the virtual reality module was supported by a grant from the Children’s National Board of Visitors.


    Article Information

    Published: February 09, 2016

    DOI

    10.7759/cureus.486

    Cite this article as:

    Zaveri P P, Davis A B, O'connell K J, et al. (February 09, 2016) Virtual Reality for Pediatric Sedation: A Randomized Controlled Trial Using Simulation . Cureus 8(2): e486. doi:10.7759/cureus.486

    Publication history

    Received by Cureus: October 30, 2015
    Peer review began: November 09, 2015
    Peer review concluded: January 28, 2016
    Published: February 09, 2016

    Copyright

    © Copyright 2016
    Zaveri et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Introduction: Team training for procedural sedation for pediatric residents has traditionally consisted of didactic presentations and simulated scenarios using high-fidelity mannequins. We assessed the effectiveness of a virtual reality module in teaching preparation for and management of sedation for procedures.

Methods: After developing a virtual reality environment in Second Life® (Linden Lab, San Francisco, CA) where providers perform and recover patients from procedural sedation, we conducted a randomized controlled trial to assess the effectiveness of the virtual reality module versus a traditional web-based educational module. A 20 question pre- and post-test was administered to assess knowledge change. All subjects participated in a simulated pediatric procedural sedation scenario that was video recorded for review and assessed using a 32-point checklist. A brief survey elicited feedback on the virtual reality module and the simulation scenario.

Results: The median score on the assessment checklist was 75% for the intervention group and 70% for the control group (P = 0.32). For the knowledge tests, there was no statistically significant difference between the groups (P = 0.14). Users had excellent reviews of the virtual reality module and reported that the module added to their education.

Conclusions: Pediatric residents performed similarly in simulation and on a knowledge test after a virtual reality module compared with a traditional web-based module on procedural sedation. Although users enjoyed the virtual reality experience, these results question the value virtual reality adds in improving the performance of trainees. Further inquiry is needed into how virtual reality provides true value in simulation-based education.



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Create a free account to continue reading this article.

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Pavan P. Zaveri, M.D., Assistant Professor

Division of Emergency Medicine, Children's National Health System

For correspondence:
pzaveri@childrensnational.org

Aisha B. Davis

Division of Hospital Medicine, Children's National Health System

Karen J. O'Connell

Division of Emergency Medicine, Children's National Health System

Emily Willner

Division of Emergency Medicine, Children's National Health System

Dana A. Aronson Schinasi

Division of Emergency Medicine, Lurie Children's Hospital

Mary Ottolini

Division of Hospital Medicine, Children's National Health System

Pavan P. Zaveri, M.D., Assistant Professor

Division of Emergency Medicine, Children's National Health System

For correspondence:
pzaveri@childrensnational.org

Aisha B. Davis

Division of Hospital Medicine, Children's National Health System

Karen J. O'Connell

Division of Emergency Medicine, Children's National Health System

Emily Willner

Division of Emergency Medicine, Children's National Health System

Dana A. Aronson Schinasi

Division of Emergency Medicine, Lurie Children's Hospital

Mary Ottolini

Division of Hospital Medicine, Children's National Health System