Luis Llerena, MD
Associate Professor of Surgery
USF Health Professional Conferencing
Tampa, Florida
Disclosure information not submitted.
Shannon Bailey, PhD
Human Factors Scientist
Immertec (Immersive Tech Inc.), United States
Disclosure information not submitted.
Michael Brannick, PhD
Professor Emeritus
University of South Florida, Department of Psychology, United States
Disclosure information not submitted.
Colleen Reiner, Ed.M.
Interim Director of Education
University of South Florida, Center for Advanced Medical Learning and Simulation, United States
Disclosure information not submitted.
Bilgi Akyuz, M.Eng.
Hardware Engineer
Immertec (Immersive Tech Inc.), United States
Disclosure information not submitted.
Shawn Taber
Simulation Operations Specialist II.
University of South Florida, Center for Advanced Medical Learning and Simulation, United States
Disclosure information not submitted.
Lauren Dyer, BS
Medical Student
University of South Florida, Morsani College of Medicine, United States
Disclosure information not submitted.
Lauren Danker, BS
Conference & Events Planner
University of South Florida, Center for Advanced Medical Learning and Simulation, United States
Disclosure information not submitted.
Title: Remote Instruction of Airway Intubation using Virtual Reality: A Randomized Controlled Trial
Introduction/Hypothesis: Airway intubation is essential for critical care. Prompted by COVID restrictions on in-person instruction, we evaluated a novel method of remotely training airway intubation: livestreaming in immersive virtual reality (VR). We hypothesized that performance on the procedure, confidence, and subjective experience ratings would be higher for training with VR than a 2D display control.
Method: 26 preclinical medical students participated (Mage=24 years, SD=2.2 years; 50% were female). After IRB approval, 13 participants were assigned randomly to each condition: VR or 2D display (control). Participants used either VR or 2D display to receive instruction on airway intubation. Participants reported their confidence pre/post-training and rated their experience with the technology on Likert items. Participants then attempted the procedure on a manikin using a video assisted laryngoscope.
Results: The average percent correct on the airway intubation procedure was 68% in the VR group (SD=19%) and 60% in the 2D group (SD=22%), but performance did not differ significantly by group (t[24]=0.996, p=.17, d=0.39, all reported p values are 1-tailed). Both groups reported more confidence following training (F[1,24]=72.89, p< .001, ηp2=0.75), but confidence did not differ by group (F[1,24]=0.797, p=0.38, ηp2=0.03). On the Likert items, participants rated VR as a more acceptable format than 2D display for airway intubation training (t[24]=1.691, p=.05, d=0.66), and rated the sound quality higher for VR (t[24]=1.712, p=.05, d=0.68). The other Likert items were rated in the predicted direction but did not reach significance: Enjoyment (t[19.81]=1.157, p=.13, d=0.45), Satisfaction (t[24]=1.254, p=.11, d=0.49), and Acceptability of Camera Placement (t[24] = 0.494, p=.31, d=0.19). Usability scores also did not differ by group (t[23]=-.200, p=.42, d=-0.08).
Conclusions: Medical students rated VR as more acceptable for training airway intubation than a 2D display, but VR did not significantly affect performance or confidence when compared to an instructionally-equivalent 2D display condition. Most results were in the predicted direction with medium effect sizes, but statistical power was only sufficient for large effect sizes. Thus, further research is warranted on the degree to which VR adds value to remote training.