VR Effective Substitute for Nurse-Physician Communication Team Training


VR is a promising learning strategy to prepare students to be part of a collaborative workforce.

Sok Ying Liaw, PhD

Sok Ying Liaw, PhD

Findings of a recent study supported the potential use of virtual reality (VR) to substitute conventual simulations for communication team training.

Sok Ying Liaw, PhD, and a team of colleagues from Singapore implemented training using tools to evaluate a virtual reality (VR) program versus live simulations on medical and nursing students’ communication skill performances and teamwork attitudes. The investigators found that there was no inferiority of team training using VR when compared with live simulations.

Liaw, from the National University of Singapore, and the investigative team used social media to recruit volunteers who were in their third or fourth year of medicine or nursing courses. The participants were divided by healthcare courses taken and year of study. Then, they were randomly assigned to the virtual or simulation group. Each participant was grouped into an interprofessional team of 2 medical students and 2 nursing students.

Both the participants in the virtual and live groups underwent 3 hours of team training on nurse-physician communication conduced in the university’s center for healthcare simulations. Participants completed a 20-minute computer-based lesson on communication skill strategies, which included ISBAR; Concerned, Uncomfortable, and Safety; feedback to acknowledge; callout; and check back.

Those in the virtual group stay in the computer lab to complete the VR simulation. With their teammate, a facilitator, and a simulated patient, they logged into a 3D environment using their avatar. Participants in the virtual group had an orientation where they learned to navigate between tutorial room and ward settings, talk among themselves using headsets, and perform assessments on the patient avatar.

For participants in the live simulation group, they were brought into a simulated ward setting and had an orientation on the setup, the equipment, and a standardized patient.

There were 2 scenarios: the first simulated a morning round situation of a postoperative patient with sepsis conditions, and the second involved the same patient whose condition deteriorated into septic shock. The scenarios started with the nursing student performing an assessment on the patient and communicating to the medical participant. Nursing participants were expected to use communication strategies to communicate their findings.

Medical participants then performed physical assessments and used the communication strategies by acknowledging the nurse’s concerns and communicate treatment plans.

The scenarios lasted 15-20 minutes each and were followed up by a 30-minute debriefing led by a facilitator.

Participants completed the Attitudes Toward Interprofessional Health Care Team (ATHCT) and Interprofessional Socialization and Valuing Scale (ISVS) questionnaires at baseline and immediately after the scenarios, along with 2 months after the simulation training.

Overall, 160 participants completed the study and a majority (67.5%) were female.

A team-based simulation assessment showed no significant differences in the communication performance post-test scores (P=.29) between the virtual (mean, 22.6) and simulation groups (mean, 23.97). There were no significant differences in the total checklist post-test scores (P=.29) and global post-test scores (P=.29) between both groups.

There were no significant differences at baseline in the ATHCT (P=.33) and ISVS (P=.45) scores between both groups. After training, there was a significant increase in post-test scores from baselines scores for both groups. There was a significant increase in follow-up ISVS scores from baseline for the VR group (P=.047) and not for the simulation group (P=.14).

VR could be a promising learning strategy to prepare students to be part of a collaborative workforce and provide safe and quality patient care, the study authors concluded.

The study, “Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes,” was published online in the Journal of Medical Internet Research.

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