Use of Virtual Reality for Pediatric Cardiac Critical Care Simulation

Abstract

Simulation is a key component of training in the pediatric cardiac intensive care unit (CICU), a complex environment that lends itself to virtual reality (VR)-based simulations. However, VR has not been previously described for this purpose. Two simulations were developed to test the use of VR in simulating pediatric CICU clinical scenarios, one simulating junctional ectopic tachycardia and low cardiac output syndrome, and the other simulating acute respiratory failure in a patient with suspected coronavirus disease 2019. Six attending pediatric cardiac critical care physicians were recruited to participate in the simulations as a pilot test of VR's feasibility for educational and practice improvement efforts in this highly specialized clinical environment. All participants successfully navigated the VR environment and met the critical endpoints of the two clinical scenarios. Qualitative feedback was overall positive with some specific critiques regarding limited realism in some mechanical aspects of the simulation. This is the first described use of VR in pediatric cardiac critical care simulation.

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review

“…Second, desktop VR–based training was used successfully for teaching nursing content [ 72 , 75 , 78 ] and urology [ 84 ]. Third, immersive VR experiences helped simulate pediatric ICU clinical scenarios, with some specific critiques regarding limited realism in some mechanical aspects of the simulation [ 99 ].…”

“…The most adopted VR content was 360° videos or photos, used in 11 studies. Eight studies used virtual environments, 2 studies adopted VR video games [ 79 , 90 ], 5 studies used embodied agents [ 48 , 78 , 99 , 101 , 104 ], 4 studies used hybrid content (ie, a mix of 360° videos or photo and virtual environments or VR video games) [ 49 , 70 , 93 , 100 ], and 1 study did not specify the content [ 85 ] ( Table 4 ).…”

The horizon of pediatric cardiac critical care

“…VRbased training may provide improved accessibility by using a computer or virtual platform, allowing trainees to learn asynchronously and independently (30,31). The use of VR simulations for junctional ectopic tachycardia and low cardiac output syndrome have been used for physician trainees, noting that participants had positive feedback using this interface (32). The Stanford Virtual Heart project has been developed as another resource for learners to interact with various congenital heart malformations, focus on their spatial relationships with other heart structures (31).…”

“…The Stanford Virtual Heart project has been developed as another resource for learners to interact with various congenital heart malformations, focus on their spatial relationships with other heart structures (31). Further research is needed to describe the effectiveness of learning with this new technology, including in PCCC (32).…”

Pediatric Critical Care in Resource Limited Settings—Lessening the Gap Through Ongoing Collaboration, Advancement in Research and Technological Innovations

“…Simulation technology and educational strategies are being increasingly adapted to low-resource settings ( 30 ). Simulation can be “hands on” ( 31 ), virtual reality ( 32 , 33 ), or screen based ( 34 ). Organizations producing mannequins “not-for-profit” have helped advance “hands-on” simulation in LMICs in the last 10 years, as have trainings designed specifically for PCC in low resources settings ( 35 ).…”