Virtual reality simulation as a training tool for perfusionists in extracorporeal circulation: Establishing face and content validity
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ABSTRACT:
SUBMITTER: Babar Z
PROVIDER: S-EPMC10579814 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
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Project description:BackgroundCardiac arrest after cardiac surgery commonly has a reversible cause, where emergency resternotomy is often required for treatment, as recommended by international guidelines. We have developed a virtual reality (VR) simulation for training of cardiopulmonary resuscitation (CPR) and emergency resternotomy procedures after cardiac surgery, the Cardiopulmonary Resuscitation Virtual Reality Simulator (CPVR-sim). Two fictive clinical scenarios were used: one case of pulseless electrical activity (PEA) and a combined case of PEA and ventricular fibrillation. In this prospective study, we researched the face validity and content validity of the CPVR-sim.ObjectiveWe designed a prospective study to assess the feasibility and to establish the face and content validity of two clinical scenarios (shockable and nonshockable cardiac arrest) of the CPVR-sim partly divided into a group of novices and experts in performing CPR and emergency resternotomies in patients after cardiac surgery.MethodsClinicians (staff cardiothoracic surgeons, physicians, surgical residents, nurse practitioners, and medical students) participated in this study and performed two different scenarios, either PEA or combined PEA and ventricular fibrillation. All participants (N=41) performed a simulation and completed the questionnaire rating the simulator's usefulness, satisfaction, ease of use, effectiveness, and immersiveness to assess face validity and content validity.ResultsResponses toward face validity and content validity were predominantly positive in both groups. Most participants in the PEA scenario (n=26, 87%) felt actively involved in the simulation, and 23 (77%) participants felt in charge of the situation. The participants thought it was easy to learn how to interact with the software (n=24, 80%) and thought that the software responded adequately (n=21, 70%). All 15 (100%) expert participants preferred VR training as an addition to conventional training. Moreover, 13 (87%) of the expert participants would recommend VR training to other colleagues, and 14 (93%) of the expert participants thought the CPVR-sim was a useful method to train for infrequent post-cardiac surgery emergencies requiring CPR. Additionally, 10 (91%) of the participants thought it was easy to move in the VR environment, and that the CPVR-sim responded adequately in this scenario.ConclusionsWe developed a proof-of-concept VR simulation for CPR training with two scenarios of a patient after cardiac surgery, which participants found was immersive and useful. By proving the face validity and content validity of the CPVR-sim, we present the first step toward a cardiothoracic surgery VR training platform.
| S-EPMC8928050 | biostudies-literature
Project description:PurposeTo test the face validity of the hip diagnostics module of a virtual reality hip arthroscopy simulator.MethodsA total of 25 orthopaedic surgeons, 7 faculty members and 18 orthopaedic residents, performed diagnostic supine hip arthroscopies of a healthy virtual reality hip joint using a 70° arthroscope. Twelve specific targets were visualised within the central compartment; six via the anterior portal, three via the anterolateral portal and three via the posterolateral portal. This task was immediately followed by a questionnaire regarding the realism and training capability of the system. This consisted of seven questions addressing the verisimilitude of the simulator and five questions addressing the training environment of the simulator. Each question consisted of a statement stem and 10-point Likert scale. Following similar work in surgical simulators, a rating of 7 or above was considered an acceptable level of realism.ResultsThe diagnostic hip arthroscopy module was found to have an acceptable level of realism in all domains apart from the tactile feedback received from the soft tissue. 23 out of 25 participants (92%) felt the simulator provided a non-threatening learning environment and 22 participants (88%) stated they enjoyed using the simulator. It was most frequently agreed that the level of trainees who would benefit most from the simulator were registrars and fellows (22 participants; 88%). Additionally, 21 of the participants (84%) agreed that this would be a beneficial training modality for foundation and core trainees, and 20 participants (80%) agreed that his would be beneficial for consultants.ConclusionsThis VR hip arthroscopy simulator was demonstrated to have a sufficient level of realism, thus establishing its face validity. These results suggest this simulator has sufficient realism for use in the acquisition of basic arthroscopic skills and supports its use in orthopaedics surgical training.Level of evidenceI.
| S-EPMC6754348 | biostudies-literature
Project description:Background and study aims Virtual reality endoscopic simulation training has the potential to expedite competency development in novice trainees. However, simulation platforms must be realistic and confer face validity. This study aimed to determine the face validity of high-fidelity virtual reality simulation (EndoSim, Surgical Science, Gothenburg), and establish benchmark metrics to guide the development of a Simulation Pathway to Improve Competency in Endoscopy (SPICE). Methods A pilot cohort of four experts rated simulated exercises (Likert scale score 1-5) and following iterative development, 10 experts completed 13 simulator-based endoscopy exercises amounting to 859 total metric values. Results Expert metric performance demonstrated equivalence ( P = 0.992). In contrast, face validity of each exercise varied among experts (median 4 (interquartile range [IQR] 3-5), P < 0.003) with Mucosal Examination receiving the highest scores (median 5 [IQR 4.5-5], P = 1.000) and Loop Management and Intubation exercises receiving the lowest scores (median 3 [IQR 1-3], P < 0.001, P = 0.004), respectively. The provisional validated SPICE comprised 13 exercises with pass marks and allowance buffers defined by median and IQR expert performance. Conclusions EndoSim Face Validity was very good related to early scope handling skills, but more advanced competencies and translation of acquired clinical skills require further research within an established training program. The existing training deficit with superadded adverse effects of the COVID pandemic make this initiative an urgent priority.
| S-EPMC9473829 | biostudies-literature
Project description: Not available
| S-EPMC7331115 | biostudies-literature
Project description:Purpose/objectiveDeficits in executive functions are prevalent among children with traumatic brain injury (TBI). Assessing cognitive impairment is critical for evaluating and monitoring recovery. The present article reports a pilot study to evaluate the preliminary usability and validity of a virtual reality cognitive assessment tool (VR-CAT) specifically designed for children with TBI.Research method/designA total of 54 children, 24 with TBI and 30 with orthopedic injury, participated in a cross-sectional cohort study at a Level-1 trauma center. The VR-CAT was evaluated in terms of user experience as well as preliminary psychometric properties including test-retest reliability, face validity, concurrent validity with two standard executive function assessment tools, and utility in distinguishing the TBI and orthopedic injury groups.ResultsChildren in both groups reported high levels of usability (i.e., enjoyment and motivation). The VR-CAT composite and scores on tests of inhibitory control and working memory demonstrated modest test-retest reliability across two independent assessment visits, as well as acceptable face validity, modest concurrent validity, and clinical utility.Conclusions/implicationsThe present study is among the first to evaluate the applicability of an immersive VR-CAT in children with TBI. The findings support high usability, adequate psychometric properties, and satisfactory clinical utility of the VR-CAT, suggesting it is a promising tool for assessing executive functions in this vulnerable population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
| S-EPMC10165731 | biostudies-literature
Project description:PurposeLimited data exist on the actual transfer of skills learned using a virtual reality (VR) simulator for arthroscopy training because studies mainly focused on VR performance improvement and not on transfer to real word (transfer validity). The purpose of this single-blinded, controlled trial was to objectively investigate transfer validity in the context of initial knee arthroscopy training.MethodsFor this study, 36 junior resident orthopaedic surgeons (postgraduate year one and year two) without prior experience in arthroscopic surgery were enrolled to receive standard knee arthroscopy surgery training (NON-VR group) or standard training plus training on a hybrid virtual reality knee arthroscopy simulator (1 h/month) (VR group). At inclusion, all participants completed a questionnaire on their current arthroscopic technical skills. After 6 months of training, both groups performed three exercises that were evaluated independently by two blinded trainers: i) arthroscopic partial meniscectomy on a bench-top knee simulator; ii) supervised diagnostic knee arthroscopy on a cadaveric knee; and iii) supervised knee partial meniscectomy on a cadaveric knee. Training level was determined with the Arthroscopic Surgical Skill Evaluation Tool (ASSET) score.ResultsOverall, performance (ASSET scores) was better in the VR group than NON-VR group (difference in the global scores: p < 0.001, in bench-top meniscectomy scores: p = 0.03, in diagnostic knee arthroscopy on a cadaveric knee scores: p = 0.04, and in partial meniscectomy on a cadaveric knee scores: p = 0.02). Subgroup analysis by postgraduate year showed that the year-one NON-VR subgroup performed worse than the other subgroups, regardless of the exercise.ConclusionThis study showed the transferability of the technical skills acquired by novice residents on a hybrid virtual reality simulator to the bench-top and cadaveric models. Surgical skill acquired with a VR arthroscopy surgical simulator might safely improve arthroscopy competences in the operating room, also helping to standardise resident training and follow their progress.Level of evidence: 2
| S-EPMC10721743 | biostudies-literature
Project description:BackgroundCurrent scales to measure motor impairment in adults with spina bifida (SB) are limited by their complexity, variable interpretation (i.e., subjectively defined impairment levels), or inclusion of muscles groups that are not always practical to test in a clinical setting.ObjectivesA novel motor impairment tool for adults with SB was evaluated for content validity. The tool uses findings from the manual muscle testing of hip flexion and knee extension to categorize individuals into four motor impairment groups.MethodsExpert feedback was obtained on the tool, and content validity was measured using Lawshe's content validity ratio (CVR) with critical values recommended by Ayre and Scally. Data from phase 1 and phase 2 were used to revise the survey and calculate the CVR of the tool, respectively (benchmark: CVR ≥ 0.636).ResultsOf the 26 experts recruited, 17 received the survey and 15 participated in either phase 1 (n = 6) or 2 (n = 11). The CVR values for each impairment group were as follows: intact strength (0.95), thoracic strength (0.90), hip flexor dominant strength (0.89), and knee extensor dominant strength (0.82). The CVR of the tool overall was 0.89. Qualitative expert feedback revealed common barriers to manual muscle testing and suggestions for improving the tool. However, experts also noted the value in preserving the simplicity of the tool.ConclusionThe high content validity, coupled with expert feedback, suggests the tool may give clinicians and researchers a practical method of classifying an individual's extent of motor impairment.
| S-EPMC9394068 | biostudies-literature
Project description:PurposeNystagmus is characterised by involuntary eye movement. A proportion of those with nystagmus experience the world constantly in motion as their eyes move: a symptom known as oscillopsia. Individuals with oscillopsia can be incapacitated and often feel neglected due to limited treatment options. Effective communication of the condition is challenging and no tools to aid communication exist. This paper describes a virtual reality (VR) application that recreates the effects of oscillopsia, enabling others to appreciate the condition.MethodsEye tracking data was incorporated into a VR oscillopsia simulator and released as a smartphone app - "Nystagmus Oscillopsia Sim VR". When a smartphone is used in conjunction with a Google Cardboard headset, it presents an erratic image consistent with oscillopsia. The oscillopsia simulation was appraised by six participants for its representativeness. These individuals have nystagmus and had previously experienced oscillopsia but were not currently symptomatic; they were therefore uniquely placed to judge the app. The participants filled in a questionnaire to record impressions and the usefulness of the app.ResultsThe published app has been downloaded ~3700 times (28/02/2018) and received positive feedback from the nystagmus community. The validation study questionnaire scored the accuracy of the simulation an average of 7.8/10 while its ability to aid communication received 9.2/10.ConclusionThe evidence indicates that the simulation can effectively recreate the sensation of oscillopsia and facilitate effective communication of the symptoms associated with the condition. This has implications for communication of other visual conditions.
| S-EPMC7510383 | biostudies-literature
Project description:During the COVID-19 pandemic several behavioral measures have been implemented to reduce viral transmission. While these measures reduce the risk of infections, they may also increase risk behavior. Here, we experimentally investigate the influence of face masks on physical distancing. Eighty-four participants with or without face masks passed virtual agents in a supermarket environment to reach a target while interpersonal distance was recorded. Agents differed in wearing face masks and age (young, elderly). In addition, situational constraints varied in whether keeping a distance of 1.5 m required an effortful detour or not. Wearing face masks (both self and other) reduced physical distancing. This reduction was most prominent when keeping the recommended distance was effortful, suggesting an influence of situational constraints. Similarly, increased distances to elderly were only observed when keeping a recommended distance was effortless. These findings highlight contextual constraints in compensation behavior and have important implications for safety policies.
| S-EPMC8828850 | biostudies-literature
Project description:Assessment of parents' child feeding behavior is challenging, and there is need for additional methodological approaches. Virtual reality technology allows for the creation of behavioral measures, and its implementation overcomes several limitations of existing methods. This report evaluates the validity and usability of the Virtual Reality (VR) Buffet among a sample of 52 parents of children aged 3-7. Participants served a meal of pasta and apple juice in both a virtual setting and real-world setting (counterbalanced and separated by a distractor task). They then created another meal for their child, this time choosing from the full set of food options in the VR Buffet. Finally, participants completed a food estimation task followed by a questionnaire, which assessed their perceptions of the VR Buffet. Results revealed that the amount of virtual pasta served by parents correlated significantly with the amount of real pasta they served, rs = 0.613, p < .0001, as did served amounts of virtual and real apple juice, rs = 0.822, p < .0001. Furthermore, parents' perception of the calorie content of chosen foods was significantly correlated with observed calorie content (rs = 0.438, p = .002), and parents agreed that they would feed the meal they created to their child (M = 4.43, SD = 0.82 on a 1-5 scale). The data presented here demonstrate that parent behavior in the VR Buffet is highly related to real-world behavior, and that the tool is well-rated by parents. Given the data presented and the potential benefits of the abundant behavioral data the VR Buffet can provide, we conclude that it is a valid and needed addition to the array of tools for assessing feeding behavior.
| S-EPMC5817019 | biostudies-literature