To evaluate the efficacy and perceived utility of SIMUality, an innovative academic strategy to provide simulation experiences, compared to traditional paper-based simulation to train and to evaluate doctor of physical therapy (DPT) student situational awareness and clinical decision making. SIMUality is a fully-immersive, 360-degree digital video/audio virtual reality (VR) experience viewed via head mounted displays (HMDs) of simulated patient-care scenarios in a variety of clinical environments. Simulation is a well-established strategy in healthcare professional education to provide students an opportunity to make lasting connections between didactic content and clinical practice. Many DPT programs utilize simulation as a way to measure proficiency and preparedness of their students before clinical placement. DPT programs may employ a variety of realistic simulation strategies (simulated patients, simulation labs); however, these simulation opportunities are often limited to once a semester. For more day to day simulation training and assessment, educators turn to the ubiquitous paper-case scenario where the learner visualizes themselves interacting with a patient in a clinical environment using the description provided. The advent of 360 digital video/audio cameras with 4K quality and self-stitching capacity combined with easy transfer to consumer grade HMD provides a relatively low-cost rapid implementation (compared to computer generated interactive VR) VR strategy we have named SIMUality. SIMUality transforms the content of a paper case into a realistic, fully immersive VR experience giving the DPT student a sense of physical presence in the clinical environment with the patient.
Four 40-second SIMUality scenarios were created from four traditional paper-cases to address acute care tasks in the realms of decision-making, planning, and situational awareness; all components that were identified by clinical instructors and program faculty to be uniquely challenging for DPT students in the acute care setting. Scenarios are based upon a Òdrive-byÓ planning task, with DPT students standing ÒvirtuallyÓ in the doorway of a hospital room observing a patient in a bed or chair and then creating a plan to mobilize the patient, including identifying equipment needed and room preparation. Chart review notes from the paper case are provided via a graphic on a wall (serving a similar purpose as the whiteboard in a patientÕs room) to be considered during planning. Thirty second-year DPT students in their fifth didactic semester were randomly assigned to create their mobilization plan for Patient A and Patient B from either viewing the patient in SIMUality or reading about them on Paper. This study has a double cross-over random assignment design to control for Patient (A or B) and Simulation strategy (SIMUality or Paper). Student SIMUality plans were compared to Paper plans for content related to decision making, planning and situational awareness. Overall clinical readiness was assessed from a master plan created from six practicing acute care clinicians who viewed the SIMUality cases.
Data collection is on-going. Preliminary research has shown a distinct difference in sequential task planning and situation awareness/anticipation between DPT students and acute care clinicians.
Conclusions/Relevance to the conference theme:
SIMUality places DPT students in the actual clinical setting with the patient with the relative ease and convenience of creating a paper case. SIMUality provides an innovative academic strategy for academic programs to achieve the quadruple aim of enhancing Patient Experience by providing multiple opportunities for realistic simulation practice. Standardized SIMUality scenarios may also provide an additional avenue of performance evaluation and a way to identify potential gaps in DPT curriculum. In light of the recent COVID-19 pandemic, SIMUality may help address educational challenges that have been identified by providing an immersive acute care experience when face-to-face meeting is not a viable option.