Teaching ultrasound-guided peripheral venous catheter placement through immersive virtual reality

Abstract

Introduction: Immersive virtual reality (IVR)-based training is gaining ground as an educational tool in healthcare. When combined with well-established educational methods, IVR can potentially increase competency and autonomy in ultrasound (US)-guided peripheral venous cannulation. The aim of this study was to examine the impact of adding IVR training to a course in US-guided peripheral venous cannulation. Methods: Medical students (n = 19) from the University of Southern Denmark with no former standardized US education were recruited to voluntarily participate in a pilot study, designed as a randomized controlled trial. The primary outcome was the proportion of successful peripheral venous cannulations on a phantom. Secondary outcomes included the proportion of surface punctures on the phantom and procedure time. Participants received e-learning on the basic US before randomization to either IVR (n = 10) or no further training (n = 9). The additional IVR training comprised 10 virtual scenarios for US-guided peripheral venous catheter (PVC) placement. Students were subsequently evaluated in peripheral venous cannulation by a blinded assessor. Results: The proportion of successful peripheral venous cannulations was significantly higher in the IVR group ( P ≤ .001). The proportions of successful cannulations were significantly higher in the IVR group compared to the control group for the 1st and 2nd PVC ( P = .011, P = .023), but not for the 3rd PVC ( P = .087). Similar results were found for the proportion of surface punctures (1st: P ≤ .001, 2nd: P = .001, and 3rd: P = .114). No significant differences in procedure times were found between the groups. Conclusion: This pilot study showed that adding an IVR-based training simulation to an existing e-learning curriculum significantly increased the learning efficacy of US-guided PVC placement for medical students.

A scoping review to assess the effects of virtual reality in medical education and clinical care

“… 6 , 17 , 19 – 21 , 23 , 37 Three studies incorporated pre-recorded videos for training purposes. 22 , 37 , 38 Two studies used experiential learning to help medical professionals understand the difficulties that patients faced, such as language barriers, cultural barriers, financial limits, or the impact of the disease. 24 , 37 Two studies provided additional web-based VR materials or resources to participants.…”

“…One study focused on learning efficacy. 22 The VR-based training simulation centered on tip tracking abilities in order to improve medical students’ learning efficacy in placing peripheral venous cannulas. The VR group had a considerably higher proportion of successful cannula emplacements.…”

“… 17 VR-based education has been encouraging and beneficial for building confidence in abilities, 17 – 20 self-efficacy, 6 , 21 and knowledge and skill development. 6 , 17 , 19 , 21 – 23 Moreover, VR provides a variety of other educational opportunities, including the development of nontechnical competencies, such as awareness and understanding, which are essential elements in developing empathy. 24 Due to the increasing demand for distance learning brought on by the COVID-19 pandemic, the use of VR in healthcare education has never been more prevalent than now.…”

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

“…Mastering the skill and procedures of puncture or catheterization is essential across many medical specialties. However, as an invasive operation that may cause patients discomfort and have the risk of complications, puncture or catheterization has been considered as a challenge for medical training ( 63 , 99 ). In the recent 2 years, three published articles reported the application of VR in VS training among medical undergraduates for lumbar puncture ( 25 ), ultrasound-guided peripheral venous catheter placement ( 63 ), and endotracheal intubation ( 99 ), respectively.…”

“…However, as an invasive operation that may cause patients discomfort and have the risk of complications, puncture or catheterization has been considered as a challenge for medical training ( 63 , 99 ). In the recent 2 years, three published articles reported the application of VR in VS training among medical undergraduates for lumbar puncture ( 25 ), ultrasound-guided peripheral venous catheter placement ( 63 ), and endotracheal intubation ( 99 ), respectively. The results collectively suggested that, as a teaching method well-received by students, VS training can engage learners, develop their practical competencies and proficiency in performing procedures under safe and controlled environments, facilitate spatial recognition and anatomic visualization, thus enhance medical education and skills training ( 25 , 63 , 99 ).…”