Avatar and distance simulation as a learning tool – virtual simulation technology as a facilitator or barrier? A questionnaire-based study on behalf of Netzwerk Kindersimulation e.V.

Abstract

BackgroundVirtual simulation modalities have been implemented widely since the onset of the severe acute respiratory syndrome coronavirus 2 pandemic restrictions in March 2020, as educators face persistent restrictions to face-to-face education of medical students and healthcare professionals.There is paucity of published data regarding the benefits and barriers of distance and avatar simulation training modalities.MethodsFollowing a 2-day virtual pediatric simulation competition facilitated by Netzwerk Kindersimulation e.V., using remote human avatars and distance simulation, we conducted a multicenter survey to explore the advantages and challenges of avatar and distance simulation among participants. We used a modified Delphi approach to draft and develop the 32-item online questionnaire with 7-point Likert-like scales (7 being the highest rating).ResultsTwenty participants answered our questionnaire. Respondents indicated both a high overall satisfaction (median of 5.0 [Q25–Q75: 4.0–6.0] ) for avatar and distance simulation 6.0 (5.0–6.0), respectively, as well as a high achieved psychological safety with both simulation types (5.0 [4.0–6.0] vs. 5.0 [4.0–6.0]). The most frequently reported profits of avatar and distance simulation included the elimination of travel distances, associated lower costs, less time spent attending the education activity, and effective communication and leadership training, especially with avatar simulation. Most often named challenges were technical problems, limited reception of non-verbal cues and a spatial distance from the team/educator.DiscussionBased on the results of this pilot study, avatar and distance simulation can be employed successfully and appear to be good supplements to face-to-face simulation. Other studies are warranted to further explore the effectiveness of various types of virtual simulation compared to conventional presential simulation. We suggest using avatar-based simulation for targeted communication and leadership skills training and the application of distance simulation to bring simulation experts virtually to remote places where educator resources are lacking.

Telesimulation for the Training of Medical Students in Neonatal Resuscitation

“…Informal talks with the students following their study participation clearly showed that participants valued the educational experience but would not want to have telesimulation replace face-to-face instruction. This has also been concluded by Löllgen et al [ 2 ], whose questionnaire-based study among distance simulation participants illustrated high overall satisfaction, despite limitations such as technical issues, time delays, and the (required) spatial separation. Another challenge when delivering telesimulation training can be the quality of instructor feedback [ 8 ], which requires trainers to develop “interactive skills” [ 24 ].…”

“…The COVID-19 pandemic has had a significant and enduring impact on medical education, as universities and educators were suddenly forced to develop and implement novel methods to impart knowledge and to ensure essential hands-on training while being limited by social distancing [ 1 ]. Simulation educators often switched their face-to-face programs to virtual simulation training, distance simulation or telesimulation in order to sustain their curricula [ 2 ], although there were significant differences in preparedness and successful implementation of distance simulation or remotely facilitated training between geographic regions [ 3 ].…”

Recommendations of the Netzwerk Kindersimulation for the Implementation of Simulation-Based Pediatric Team Trainings: A Delphi Process

“…Our work constitutes comprehensive, up-to-date, consensus- and evidence-based guidelines for the implementation of SB team trainings and debriefings. These elaborated quality standards for the implementation of SB education were translated from German [ 11 ] to English [ 12 ] for broader use across the simulation educator community. Our recommendations were adopted as international guidelines by the Swiss Society of Pediatrics (SGP/SSP), the German Society for Neonatology and Pediatric Intensive Care (GNPI), and the Austrian Society of Pediatrics (ÖGKJ).…”

“…Only a few previously published pediatric guidelines exist [ 6 ], and most are not explicitly dedicated to the field of pediatrics [ 7 , 29 ] or are designed for other specific fields, e.g., nursing [ 30 ] or surgery [ 31 ]. The NKS quality criteria guidelines resulting from the Delphi process fill this knowledge gap [ 11 , 12 ].…”

“…Finally, the German document was formally language copy-edited by a German language teacher [ 11 ] (see Supplementary Materials File S1 ). This language-edited German version was then professionally translated into English [ 12 ] (see Supplementary Materials File S2 ).…”