Background
Physical examination involves clinical skills where therapists or trainees use their hands to assess tissues or joints for the presence or absences of abnormalities. The traditional “See one, do one, teach one” approach to teach these techniques has been shown to be inadequate. Therefore, digital applications such as virtual reality (VR) have been recommended to assist in teaching physical examination skills of health care students. The aims of this systematic review are to 1) Summarise the level of evidence for the current usage of VR with haptic feedback in health education for improving physical assessment skills among students; and (2) To synthesise the literature on facilitators and barriers for implementing VR with haptic feedback as a health education tool in improving physical assessment skills of students.
Methods
The following electronic databases were searched: PubMed, AMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database (PEDro), and SCOPUS. Two independent reviewers reviewed the articles retrieved from the databases to assess for eligibility. Studies of any methodology (quantitative, qualitative and mixed methods) that investigated the use of VR were included in the review. Primary outcomes included any quantifiable outcome and/or qualitative outcome/feedback. Narrative synthesis was used to synthesise data from the included studies.
Results
A total of 9 studies were included in the final review. Overall, our review found ‘very low’ evidence that VR with haptic feedback may improve palpation of stiffness, palpation speed and palpation accuracy. A ‘conditional recommendation of the intervention’ depending on the context, access and resources required to set-up the required technology.
Discussion
Our review indicates that VR with haptic feedback may enhance palpatory skills of health care students. However, the applicability of evidence may be confined to palpatory skills of health students rather than physical examination skills of health students. Hence, more research is required to identify whether VR with haptic feedback does improve physical examination skill of students.