Results

A total of 42 residents completed the VR experience and post-experience surveys, and two residents participated in the semi-structured interview. Please see Table 1 for full demographics.

 | N (total = 42) | %
Residency Program |  | 
Pediatric | 20 | 47.6
Emergency Medicine | 22 | 52.4
Post-graduate year of training (PGY) |  | 
PGY-1 | 14 | 33.3
PGY-2 | 13 | 31.0
PGY-3 | 9 | 21.4
PGY-4 | 6 | 14.3

Learning methods

Residents were asked to select their traditional method(s) of learning during the Pediatric Emergency Medicine rotation, as shown in Figure 3.

Figure 3: Learner's preferred teaching methods for pediatric trauma

The majority of residents supplemented their clinical rotation with simulation (n=36, 85.7%), reading (n=25, 59.5%), video lectures (n=22, 52.4%), with fewer residents learning through podcasts/audio (n=9, 21.4%). One resident (n=1, 2.4%) indicated “Other” with their learning style reported as “on shift learning.”

Curriculum evaluation

The post-experience survey was used for evaluation of the new curriculum. Questions asked for feedback about comfort of the experience, ease of use, and usefulness of VR as an educational method, and applicability of the information presented (Figure 4).

Figure 4: Responses on the virtual reality experience based on comfort, ease of use, usefulness, and applicability

Comfort

Most participants indicated that they found the VR experience ‘very comfortable’ (n=28, 66.7%) or ‘somewhat comfortable’ (n=12, 28.6%).

Ease of Use

Most learners indicated that they found the VR headset ‘easy to use’ (n=37, 88.1%) or ‘somewhat easy to use’ (n=5, 11.9%).

Usefulness

Most residents indicated that they found the VR experience overall useful when compared to existing resources, such as lectures, podcasts, and simulation, indicating ‘very useful’ (n=36, 85.7%) or ‘somewhat useful’ (n=6, 14.3%).

Applicability

Most participants found the information presented ‘very applicable’ (n=39, 92.9%) or ‘somewhat applicable’ (n=2, 4.8%).

Additional questions inquired about the opinions of the participants on incorporation of VR into their regular curriculum and whether they would use VR headsets for independent learning (Figure 5).

Figure 5: Additional survey responses

Most participants indicated that they thought VR should be incorporated into the Pediatric Emergency Medicine curriculum (n=38, 90.5%). Additionally, most indicated that they would use VR headsets for independent learning if they were available (n=29, 69.0%).

Survey responses and semi-structured interviews

Qualitative analysis was conducted on transcribed curriculum feedback from study participants as well as two post-experience interviews conducted by the study co-investigator. Themes with select quotations are presented in Table 2.

Theme | Subtheme | Selected quotes
Experiential Learning | Realism | "Feel like you’re in a room."
"Actually feeling like you’re in the room, and seeing the decisions being made in real time."
"The virtual reality like did a good job at incorporating those things to help prepare you for a real situation like that."
New Learner | "I had never been in a code before so seeing... it was like giving me a sense of if I ever am in a code, like this is what my role could possibly look like."
"It would be really good towards quickly dropping someone into a new setting... and then getting them up to speed fairly quickly."
“It would be great to use in the beginning of the year to get residents acclimated to the trauma slot and the way traumas are run.’
Learning algorithms | It’s more important to understand the algorithm and when to apply specific principles, and I think that VR does as good as, if not a better job, than traditional lecture style.
Learning adjunct | Pause & Reflect | "You can kind of pause time, think critically, and then continue after you make your educated guess..."
"In a real scenario... you won’t have the time to stop in the middle of each step and teach."
Enhance learning | "Virtual reality is definitely more... effective in helping me learn because reading it is much different than actually being in a room."
"It’s a visual medium... and you can experientially learn a little bit easier through a guided course."
Patient Safety | “You can’t harm a patient or family if you’re just doing a virtual reality scenario as opposed to doing like an actual scenario where someone’s life is actually at stake.”
“[We could] do this for real life scenarios and then watch to determine areas for improvement.”
Areas for Improvement | Engagement & Interactivity | "I think having multiple scenarios that run in parallel—like a decision tree."
“I really liked pushing the buttons to play the videos, maybe you could increase the interaction, like ask a question and I have to choose the answer to move on, and the video discusses it.”
“Can do questions at the end / multiple choice.”
“It would have been cool to have an interactive portion, such as some sort of quiz at the end.”
“Maybe more side videos/ interactive elements. Video is great as it is, but more interaction/ options to answer questions would be great.”
Tailoring to learner level | “Have different levels of sim for people with different knowledge base and more experience.”
“Skip the teaching pieces if you are familiar with the topic.”
Other limitations | Virtual vs physical | “A complication that I don’t necessarily think that a VR experience would be able to replicate because it’s a tactile physical exam.”
Art of medicine | “For the art of medicine maybe the VR component has less utility because there is a definitive end point to each scenario.”