Virtual Reality Simulator versus Conventional Advanced Life Support Training for Cardiopulmonary Resuscitation Post-Cardiac Surgery: A Randomized Controlled Trial

Abstract

External chest compressions are often ineffective for patients arresting after cardiac surgery, for whom emergency resternotomy may be required. A single-blinded randomized controlled trial (RCT) was performed, with participants being randomized to a virtual reality (VR) Cardiac Surgical Unit Advanced Life Support (CSU-ALS) simulator training arm or a conventional classroom CSU-ALS training arm. Twenty-eight cardiothoracic surgery (CTS) residents were included and subsequently assessed in a moulage scenario in groups of two, either participating as a leader or surgeon. The primary binary outcomes were two time targets: (1) delivering three stacked shocks within 1 min and (2) resternotomy within 5 min. Secondary outcomes were the number of protocol mistakes made and a questionnaire after the VR simulator. The conventional training group administered stacked shocks within 1 min in 43% (n = 6) of cases, and none in the VR group reached this target, missing it by an average of 25 s. The resternotomy time target was reached in 100% of the cases (n = 14) in the conventional training group and in 83% of the cases (n = 10) in the VR group. The VR group made 11 mistakes in total versus 15 for those who underwent conventional training. Participants reported that the VR simulator was useful and easy to use. The results show that the VR simulator can provide adequate CSU-ALS training. Moreover, VR training results in fewer mistakes suggesting that repetitive practice in an immersive environment improves skills.

Virtual Reality for Cardiopulmonary Resuscitation Healthcare Professionals Training: A Systematic Review

“…There were included 15 studies (Table 1 ) published between 2013 and 2023 and conducted in Europe [ 18 , 19 , 27 – 29 ], in North America [ 20 , 24 , 25 , 31 ], in Africa [ 32 , 33 ], in Asia [ 26 , 30 ], and in Central America [ 23 ]; one study did not report the country [ 22 ].…”

“…Six were primarily aiming to investigate the efficacy of VR CPR training [ 18 , 23 , 25 , 29 , 31 , 33 ], four its feasibility [ 22 , 28 , 29 , 32 ], three its utility [ 19 , 24 , 30 ], and two its usability [ 20 , 26 ]. To reach these aims, six were RCTs [ 22 , 25 , 27 , 29 , 31 , 33 ], six were cross-sectional studies [ 19 , 20 , 24 , 26 , 28 , 30 ] , and three quasi experimental [ 18 , 23 , 32 ] .…”

“…Basic CPR maneuvers were the target of eight studies [ 19 , 22 , 23 , 26 , 29 , 30 , 32 , 33 ], while the remaining considered advanced CPR maneuvers [ 18 , 20 , 24 , 25 , 27 , 28 , 31 ]. Moreover, five studies focused on the initial CPR training [ 20 , 22 , 25 , 27 , 32 ], two the retraining [ 24 , 33 ], while the remainder did not specify [ 18 , 19 , 23 , 26 , 28 – 31 ].…”

“…Basic CPR maneuvers were the target of eight studies [ 19 , 22 , 23 , 26 , 29 , 30 , 32 , 33 ], while the remaining considered advanced CPR maneuvers [ 18 , 20 , 24 , 25 , 27 , 28 , 31 ]. Moreover, five studies focused on the initial CPR training [ 20 , 22 , 25 , 27 , 32 ], two the retraining [ 24 , 33 ], while the remainder did not specify [ 18 , 19 , 23 , 26 , 28 – 31 ]. Studies were conducted mainly in hospitals [ 19 , 22 , 28 – 30 , 32 , 33 ], training centers [ 20 , 23 – 25 ], and universities [ 18 , 27 ]; two studies did not specify the setting [ 26 , 31 ].…”

“…Moreover, five studies focused on the initial CPR training [ 20 , 22 , 25 , 27 , 32 ], two the retraining [ 24 , 33 ], while the remainder did not specify [ 18 , 19 , 23 , 26 , 28 – 31 ]. Studies were conducted mainly in hospitals [ 19 , 22 , 28 – 30 , 32 , 33 ], training centers [ 20 , 23 – 25 ], and universities [ 18 , 27 ]; two studies did not specify the setting [ 26 , 31 ].…”