None listed
Conditions
Brief summary
Ultrasound-guided nerve blocks require integration of motor skills, visuo-spatial orientation, and cognitive processing. This complex medical procedure is usually taught through intensive one-on-one teaching with an expert tutor. VR is a computer-generated, artificial environment designed to replace real-world sensory inputs. Participants can interact within this world, using hand controllers to manipulate objects, while user head movements are replicated by shifting fields of view. Training using VR also engages muscle memory, allowing users to practice the same motor movements that they would have to reproduce in real-life situations. This trial seeks to investigate if a virtual reality teaching program be just as effective in teaching ultrasound-guided nerve blocks as a human tutor, with great potential for future medical education. It is a prospective, double-blinded, RCT, single-site study comparing the effectiveness of VR training against standard training (a face-to-face, didactic training). Participants will be medical students with no anaesthetic training at Liverpool Hospital. The VR software is a bespoke trainer programmed by the research group. Data collected will be the difference in the Global Rating Scale and composite error scores between VR and standard training groups, measured by two independent assessors. If shown to be useful, VR training has several advantages: 1. The opportunity to pre-train skills prior to attendance at hands-on workshops to reinforce teachings 2. Pre-training prior to clinical exposure, potentially reducing errors and improving safety 3. Enable remote learning, and not constrained by access to expert teaching faculty, particularly useful in COVID lockdowns 4. Computer-based learning calculates errors accurately, giving audible and visual cues which is more precise and consistent than a human teacher.
Interventions
This is a prospective, double-blinded, randomised controlled trial, single-site study comparing the effectiveness of VR training against standard training (a face-to-face, didactic training). Participants will be medical students with no experience in ultrasound-guided procedures or regional anaesthesia. Demographic data such as age, gender, years of video game use and mental health using the Depression Anxiety Stress Scale-21 will be collected.
All participants will be asked to view a 10-minut
This is a prospective, double-blinded, randomised controlled trial, single-site study comparing the effectiveness of VR training against standard training (a face-to-face, didactic training). Participants will be medical students with no experience in ultrasound-guided procedures or regional anaesthesia. Demographic data such as age, gender, years of video game use and mental health using the Depression Anxiety Stress Scale-21 will be collected. All participants will be asked to view a 10-minute online video before the training day, with a link provided 1 month in advance, which explains the basic ultrasound physics, transducer movements and needle guidance. This video is a composite of two publicly available YouTube educational videos from the Departments of Anaesthesia, University of California San Francisco, USA, and Queen Victoria Hospital, East Grinstead, UK. The practical component of the trial will be held over two consecutive days in May 2023, at the Thomas Moore simulation centre, Liverpool Hospital. All participants will be shown the video again, and their baseline needling skill will be tested. Participants will attempt an ultrasound-guided needle procedure, placing 1ml of saline above and below the target tendon structure on pork meat embedded with bovine tendon, within 600 seconds. Two assessors will independently score the performance of each participant using a global rating scale for Ultrasound Guided Regional Anaesthesia (UGRA) and composite error score checklist. Assessors are expert regional anaesthesia consultants. Participants will be asked to complete the National Aeronautics and Space Administration (NASA) task load index questionnaire (NASA-TLX), which scores mental and physical demand, effort and frustration level immediately after completion of the task. Participants will then be randomised into VR group (intervention) and standard teaching group (control). Our research group has created a bespoke VR software and holds intellectual property. There was no commercial funding or commercial conflicts of interest with the use of the VR training software. VR participants will experience 2x 30-minute sessions of VR training using the virtual reality trainer, with a 10-minute rest between sessions. Virtual reality software will be on a Lenovo gaming laptop and displayed to the participant via head mounted display with dual hand controllers. Each participant will have their own device. A researcher will be present at all times to assist with the set up and running of the VR software but will not interfere with the training. The control group will have a didactic and practical workshop. The final test will be conducted immediately after the training sessions on the same day. As the final test, all study participants will then be reassessed using baseline test; ultrasound-guided nerve blocks on the pork model. Two independent assessors will score using the same global rating scale for UGRA and composite error scale checklist. Participants will be asked to complete the NASA-TLX questionnaire again.
Sponsors
Liverpool Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Medical students who are novices to ultrasound-guided procedures or regional anaesthesia (no prior exposure to lectures, tutorials, workshops or clinical hands-on experience with ultrasound or nerve blocks).
Exclusion criteria
No exclusion criteria apart from prior exposure to ultrasound and/or regional anaesthesia procedures.
Outcome results
None listed