Search

Background: The use of virtual reality (VR) in medical education allows learners to make mistakes safely without risk to patients and to refine a range of clinical skills by repetition. However, there is still wide variability both between, and within countries regarding the amount of training delivered using VR, particularly in relation to intensive care medicine Objectives: To identify the range of uses, phase of development and effectiveness of VR for intensive care unit (ICU) staff training. Methods: The review followed the scoping review framework set out by Levac et al. (2010). A multi-database search was undertaken. All study types were included if they explored the use of VR for intensive care staff (ICU) staff training. Full paper screening, data extraction and assessment of bias was carried out by a single reviewer with verification by a second reviewer. A narrative synthesis was chosen to summarize the data. Results: The search strategy identified 647 records. Following the removal of duplicates, screening of titles, abstracts and full texts, five studies were included. VR for ICU training has primarily focused on skill acquisition for surgical procedures. The majority of studies in this area were classified to be at an early stage of assessing acceptability, tolerability and efficacy. There was very low-quality evidence that VR for ICU training is effective. Conclusions: Studies have explored the use of VR for a small number of surgical procedures and emergency patient scenarios. VR for ICU training demonstrates some potential, however further development and high-quality research is required. Research relating to virtual reality for ICU staff training is currently of weak methodological quality and as such, no recommendations to clinical practise can be made. Wherever possible when using VR for ICU staff training it should be utilized as part of a high-quality study.

Background: Virtual reality (VR) as a digital technology has developed rapidly, becoming more realistic, portable, sensory and easier to navigate. Although studies have found VR to be effective for many clinical applications, patients and clinicians have described several barriers to the successful implementation of this technology. To remove barriers for implementation of VR in health care, a greater understanding is needed of how VR can integrate into clinical environments, particularly complex settings such as an intensive care unit. Aim: This study aimed to explore the perceived barriers and facilitators for the implementation of VR exposure therapy for intensive care patients and clinical staff. Study Design: A qualitative study using an Interpretative Description approach was undertaken. Semi‐structured focus groups were conducted with 13 participants: nine patients and four health care professionals. Focus groups explored barriers and facilitators of using virtual reality (VR) exposure therapy in intensive care. Thematic analysis was employed to produce codes and themes. Results: In total, eight themes describing the perceived barriers and facilitators to implementing VR exposure therapy were identified. Four themes related to the perceived barriers of implementing VR exposure therapy in intensive care were identified: psychological, sensory, environmental and staff competency and confidence. There were a further four themes related to the perceived facilitators to the implementation of VR exposure therapy: staff training, patient capacity, orientation to technology and support during the intervention. Conclusions: This study identified novel barriers and facilitators that could be expected when implementing VR exposure therapy for patients' post‐intensive care unit stay. The findings suggest that psychological barriers of fear and apprehension were expected to provoke patient avoidance of exposure therapy. Perceived barriers for staff focused on preparedness to deliver the VR exposure therapy and a lack of technological competence. Both patients and staff stated that a comprehensive induction, orientation and training could facilitate VR exposure therapy, improving engagement. Relevance to Clinical Practice: This study has identified that with appropriate staff training, resources, and integration into current patient care pathways, VR exposure therapy may be a valuable intervention to support patient recovery following critical illness. Prior to undertaking VR exposure therapy, patients often need reassurance that side‐effects can be managed, and that they can easily control their virtual exposure experience. [ABSTRACT FROM AUTHOR]