Virtual Reality as an Adjunct to Traditional Emergency Medicine Training for Large-Bore Chest Tube Placement

Document Type

Conference Proceeding

Publication Date

5-13-2025

Publication Title

Acad Emerg Med

Keywords

checklist, chest tube, conference abstract, controlled study, emergency medicine, gamification, hematothorax, human, manikin, medical education, postgraduate student, therapy, training, virtual reality

Abstract

Intro/Background: Large-bore chest tube (LCT) placement is a core skill in emergency medicine (EM) used in complex cases requiring significant drainage, such as a hemothorax. Traditional training methods often face limitations with resources and repetition, while the shift to pigtail placements has further diminished clinical experience with LCTs. Virtual reality (VR) can serve as an accessible, immersive, controlled environment for LCT training providing the needed repeated practice for skill mastery while reducing resource consumption. Purpose/Objective: A VR LCT placement training session was created featuring a step-by- step checklist, repeated practice opportunities, real-time feedback, and a competitive leaderboard to enhance engagement. Gamification elements, such as testing the fastest procedure completion time, motivate progress. Unlike costly, space-consuming manikins that have the potential to sustain damage with repeated use, this course provides a sustainable alternative for skill development, allowing for repeated, controlled practice in a virtual setting without the limitations of traditional training tools. Methods: 14 postgraduate year 1 EM residents from an academic program completed a pre-course survey on LCT placement confidence and experience, followed by a VR LCT procedure tutorial. The residents were divided in 3 groups and rotated through VR stations equipped with headsets for the session which allowed each resident to perform multiple attempts. Module completion times were displayed on a leaderboard. A post-training survey assessed changes in confidence, module relevance, and reflective feedback. Outcomes (if available): 118 VR LCTs completed. Mean time for completion was 4 min 8 s [SD: ± 03:02, 95% CI: 01:41-17:30]. Fastest completion time was 1 min 41 s. Mean number of LCTs placed was 8.43 [SD: ± 4.15, 95% CI: 6.25-10.60]. Mean confidence levels increased following the VR session [Pre-VR: M = 3.07, SD = 1.87; Post-VR: M = 7.14, SD = 1.41; t(13) = -8.01, p < 0.001]. All participants recommended the experience and 92.9% found it clinically relevant. Summary: VR offers a novel approach in medical training, particularly for EM, where procedural competence in critical tasks is essential. The gamified nature of VR can make learning more engaging while allowing trainees to practice in a risk-free, safe environment. A key benefit of VR is the immediate feedback and repeated assessment it offers. Unlike manikin-based training, the VR LCT placement approach reduces the reliance on physical procedure kits, minimizing resource expenditure, and allows for far more opportunities for repeated practice. The outcomes of the VR LCT training session demonstrated promising results. Although the average completion time varied, participants were able to perform the procedure efficiently with the fastest placement in under 2 min. Participants averaged 8.43 LCT placements, showcasing the ability to practice a procedure multiple times without the constraints of physical resources or risk of equipment damage. Confidence rose post-session, showcasing that VR may effectively boost learners' self-assurance which is crucial in EM providing insight into performance under pressure. All learners recommended the learning experience and majority had found the course clinically relevant. Overall, the findings support VR as a valuable adjunct to traditional training, capable of improving both procedural proficiency and learner confidence with an engaging learning experience. As the technology continues to evolve, VR and similar interactive tools may become integral to medical education. Given its repeatability, affordability, and sustainability, VR warrants further investigation, particularly for high-acuity, infrequently encountered procedures. The technology's ability to replicate tactile and situational complexity of clinical care remains a challenge. Future studies should explore training in other rare, complex procedures and focus on developing standardized VR software to ensure competency requirements are met consist ntly. VR holds great promise as an adjunct to traditional training, offering a scalable, cost-effective, and engaging way to improve procedural competence.

Volume

32

Issue

S1

First Page

351

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