Introduction
Learning health-associated subjects throughout medical and nursing professional training implies the research and comprehension of a large body of materials and the acquisition of multiple skills and competencies. To improve the learning experience and outcomes, educators and healthcare leaders have strived to integrate new technologies into the curriculum and staff education programs. One of them is the virtual reality (VR) technology, which provides opportunities for simulation training and quick acquisition of anatomical knowledge, as well as psychomotor skills. Overall, the use of VR in the healthcare sector holds both a great promise and multiple challenges. Thus, the present research project will aim to explore them.
Research Questions and Project Parameters
Recent research evidence makes it clear that the VR technology can help healthcare practitioners develop and retain expertise before engaging in practice and, as a result, reduce the chance of error in such technically demanding medial fields as neurosurgery and others (Siu et al., 2016; Suri, Patra, & Meena, 2016). Based on this, the main research question is as follows: what are the benefits of using VR in the healthcare sector? Additionally, it is hypothesised that various organisational factors defining the manner VR is implemented may substantially determine the overall training outcomes. Thus, the second research question is as follows: what are the barriers to effective use of VR in the healthcare sector?
To answer the formulated questions, the data will be collected from at least thirty participants included in trainee and trainer groups that will complete the VR competency curriculum. The objective data will be gathered to inform the exploration of the first question, and it will focus on such performance measures as time, volume, and efficiency of task completion; the number of errors pre- and post-training, and so forth. The subjective data will be gathered to evaluate participants’ perceptions regarding the utility of VR, as well as organisational facilitators and obstacles to its application. The expected timeframe for project completion is eight months.
Research Framework
The philosophical basis for the present research project is the critical realism theory. According to Saunders, Lewis, and Thornhill (2015), critical realism implies that individuals’ knowledge about reality is a result of environmental and social conditioning and, therefore, it cannot be comprehended without exploring the forces involved in the knowledge formation process. Based on this, the research project is intended as a multi-level study aimed to investigate individual, group, and organisational factors.
Additionally, the study will employ the deduction approach aimed to test the proposed theory-based hypotheses. This method will allow finding casual relationships among such variables as VR training completion and practitioners’ skilfulness, organisational barriers and training effectiveness, and so forth.
Research Design
The sequential, exploratory, quantitative design will be utilised in the research project. It will take the form of an experiment because the participants will undergo an intervention (namely, engagement in VR training) yet their outcomes will not be compared with a control group. The study will also include a longitudinal element because its objective is to elucidate a change in trainees’ skills over a certain period.
To collect data, participants’ performance records will be used along with Likert-type questionnaires aimed to capture their perceptions of the intervention and its efficacy. Consequently, the data will be analysed by using both descriptive and inferential statistics tools, including median values for each research construct and regression analysis of variables.
Ethical Considerations
To ensure the ethical integrity of the study, participants will be asked to sign an informed consent form. It will briefly state the nature and purposes of research and describe procedures to which respondents will be exposed. Additionally, to minimise the chance of harm to participants’ identity, the researcher will ensure data confidentiality and anonymity during the disclosure of results. Lastly, the research integrity will be maintained through ethical utilisation of previous findings and appropriate crediting of scholars and scientists whose studies will be referred to during the literature review.
Literature Review
The search for evidence on the topic of interest was conducted through such databases as EBSCO/Academic Search Complete, Science Direct, and Medline/Pubmed. Both qualitative and quantitative studies were selected because they were deemed similarly helpful in guiding the research process and supporting the findings. The inclusion criteria were the publication year (2013-2018), the relevance of the topic of VR healthcare training, and the depth of the conducted analysis.
The chosen studies revealed that VR is more frequently used in surgical training (Siu et al., 2016; Arora et al., 2015; Suri et al., 2016; Bharathan et al., 2016). The main reason for this is the safety and educational challenges associated with performing surgeries by novice practitioners (Bharathan et al., 2016). However, VR can also be implemented for the improvement of non-surgical procedural skills in many medical fields, including cardiology (Biswas et al., 2016; Voelker et al., 2016), gastroenterology (Khan et al., 2018), and others.
Many of the empirical studies demonstrated that the use of VR leads to favourable training outcomes. For example, Voelker et al. (2016) reported a significant improvement in the mean skills score of participants who completed the VR simulation course regardless of an increase in the complexity of the simulated task. Notably, the control group in their study showed a decrease in the mean skills score over time (Voelker et al., 2016).
Bharathan et al. (2013) also revealed that, after ten VR sessions, participants’ dexterity level significantly increased, and it led to a decrease in cognitive load. Similarly, Arora et al. (2015) and Biswas et al. (2016) noted that the completion of VR training programs was associated with a decrease in learning curves due to development of greater experience in trainees. As a result, it becomes possible to reduce time while performing procedures on real patients. Additionally, Siu et al. (2016) noted that because of the potential positive effects of VR technologies on practitioners’ proficiency level, not only can they be useful for developing skills in novice practitioners but also for maintaining skills in the experienced ones.
The findings provided in the located studies make it clear that the success of VR training programs is dependent on various factors. Arora et al. (2014) stated that the ability of repetitive practice and the possibility for modification of task difficulty levels during simulation were linked to better learning outcomes.
Khan et al. (2018) made a similar observation by claiming that “a progressive‐learning curriculum that sequentially increases task difficulty provides benefit with respect to a composite score of competency over the structured VR training curriculum” (p. 3). Along with appropriate training constructs, there must be a supportive learning environment in a setting. For instance, Flower (2015) mentioned that an ongoing dialogue with an experienced teacher allows optimising learning experience and maximising favourable outcomes.
It is observed that in spite of a plethora of potentially positive effects of VR, it has some significant deficiencies. Suri et al. (2016) noted that “none of the simulators has proven to be totally immersive to provide a perfect virtual environment” and often the skills acquired by using VR training may not replicate real-life situations (p. 393). Biswas et al. (2016) also stated that this learning tool fails to help practitioners deal with complex situations involving various psycho-emotional and physiological factors such as patients’ emotional unrest, soft tissue peculiarities, and so forth. These challenges must be considered while designing a VR curriculum to improve learning experiences and outcomes.
References
Arora, A., Hall, A., Kotecha, J., Burgess, C., Khemani, S., Darzi, A.,… Tolley, N. (2015). Virtual reality simulation training in temporal bone surgery. Clinical Otolaryngology, 40(2), 153-159.
Arora, A., Lau, L., Awad, Z., Darzi, A., Singh, A., & Tolley, N. (2014). Virtual reality simulation training in otolaryngology. International Journal of Surgery, 12(2), 87-94.
Bharathan, R., Vali, S., Setchell, T., Miskry, T., Darzi, A., & Aggarwal, R. (2013). Psychomotor skills and cognitive load training on a virtual reality laparoscopic simulator for tubal surgery is effective. European Journal of Obstetrics and Gynecology, 169(2), 347-352.
Biswas, M., Patel, R., German, C., Kharod, A., Mohamed, A., Dod, H. S., … Nanda, N. C. (2016). Simulation-based training in echocardiography. Echocardiography, 33(10), 1581-1588.
Fowler, C. (2015). Virtual reality and learning: Where is the pedagogy? British Journal of Educational Technology, 46(2), 412-422.
Khan, R., Plahouras, J., Johnston, B. C., Scaffidi, M. A., Grover, S. C., & Walsh, C. M. (2018) Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy. Cochrane Database of Systematic Reviews, 8, 1-4.
Saunders, M. N. K., Lewis, P., & Thornhill, A. (2015). Research methods for business students (7th ed). Harlow, UK: Pearson Education.
Siu, K., Best, B., Kim, J., Oleynikov, D., & Ritter, F. (2016). Adaptive virtual reality training to optimize military medical skills acquisition and retention. Military Medicine, 181, 214-220.
Suri, A., Patra, D. P., & Meena, R. K. (2016). Simulation in neurosurgery: Past, present, and future. Neurology India, 64(3), 387-395.
Voelker, W., Petri, N., Tönissen, C., Störk, S., Birkemeyer, R., Kaiser, E., & Oberhoff, M. (2016). Does simulation-based training improve procedural skills of beginners in interventional cardiology?—A stratified randomized study. Journal of Interventional Cardiology, 29(1), 75-82.