Study of Virtual Simulated Resuscitation in Junior Clinicians

NCT05201950 | Completed

• 1 other identifier: DSRB 2021/00542
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators seek to examine the impact of virtual patient simulation on junior clinicians' resuscitation skills in an academic emergency department. Exposure to real life resuscitation cases is opportunistic, with variation in case mix across different junior clinicians. Junior clinicians are closely supervised during resuscitations, with limited independence to make decisions, for patient safety. High fidelity simulation, such as in-situ mock codes with a high fidelity manikin, is resource intensive. Constraints in facilitator and learner time and manpower reduce the feasibility of holding large numbers of simulations for large numbers of learners, leading to limited breadth of case mix exposure in simulation cases. Virtual patient simulation may allow greater and more uniform breadth of exposure and allow automated feedback and rapid cycle deliberate practiceacross a wide range of cases, with reduced resource intensiveness, and prepare them to better utilise limited opportunities for resuscitation during real life or high fidelity simulation. Virtual simulators have been found to be useful for improving skills rather than knowledge or attitudes in health professions education. Such skills include communication, radiograph interpretation, dermatological diagnosis, and cardiac arrest procedures. What is not known is:

1. 1.Whether going directly to in-situ simulation with a high fidelity manikin is the best learning approach for resuscitation, given its potentially detrimental high cognitive load, compared to going first to virtual patient simulation.
2. 2.Whether the benefits of virtual simulation extend beyond cardiac arrest and to other resuscitation scenarios, such as trauma, sepsis, and others.

Conditions

Education, Medical

Outcome Measures

Primary Outcomes (1)

• Score obtained in outcome assessment simulation

  Participants will be assessed by 2 independent assessors using a standardised checklist during simulation with a high fidelity manikin and standardised assistants in two scenarios: trauma, and sepsis

  At end of 3rd month of junior clinicians' emergency medicine rotation

Secondary Outcomes (1)

• Learner satisfaction

  Within one week after completion of assigned intervention

Study Arms (2)

Virtual simulation

EXPERIMENTAL

\- Virtual simulation group: Participants will log in to the virtual simulation software from home and play 2 cases (1 case of sepsis, 1 case of trauma). Learners are instructed to play each case as many times as they like within 70 minutes, to reach the highest score possible in that time. This process is proctored, with participants sharing their screen over video conferencing with study team members (JCL or LZY) to ensure adherence to time limit and cases played.

Other: Virtual simulation

Team based in situ simulation

ACTIVE COMPARATOR

\- Team based in situ simulation group: Faculty observing and debriefing learners at the mock code will be variable and consist of a wide range of NUH emergency department faculty outside of this study, due to logistical constraints in having the same faculty being present consistently in the entire year. The in situ simulation will cover 1 case of sepsis, and 1 case of trauma, with case content matched to the cases in the virtual simulation group, and time matched at 70 minutes.

Other: Team based in situ simulation

Interventions

Virtual simulation OTHER

Virtual simulation using Full-Code, a virtual simulation software with a bank of emergency medicine cases

Virtual simulation

Team based in situ simulation OTHER

In situ simulation, using a high fidelity manikin in the critical care area of the emergency department, with team members consisting of multiple junior doctors and nurses, facilitated by senior emergency medicine doctors and nurses.

Team based in situ simulation

Eligibility Criteria

• Age: 21 Years - 99 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Junior doctors scheduled to rotate through NUH emergency department for at least 3 months

You may not qualify if:

• Pregnant women will be excluded from the study as the study procedures do involve additional exposure to fellow healthcare workers, with the associated risk of COVID transmission, while there is no direct benefit in terms of generalisable knowledge about pregnancy or the fetus.

Sponsors & Collaborators

• National University Hospital, Singapore: lead

Study Sites (1)

National University Hospital

Singapore, 119074, Singapore

Location

Related Publications (1)

• Low MJW, Chan GWH, Li Z, Koh Y, Jen CL, Lee ZY, Cheng LTW. Comparison of virtual and in-person simulations for sepsis and trauma resuscitation training in Singapore: a randomized controlled trial. J Educ Eval Health Prof. 2024;21:33. doi: 10.3352/jeehp.2024.21.33. Epub 2024 Nov 18.

  PMID: 39552082 DERIVED

Study Officials

• Matthew JW Low, MBBS

  National University Hospital, Singapore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: Participants: it is not feasible to mask participants from their educational intervention Investigator: Two investigators (JCL and LZY) will not be masked as they will be scheduling and delivering interventions. The remaining investigators will be masked, including those assisting participants as standardised assistants during outcome assessment simulation. Outcome assessors: They will be masked from participants' group assignment.
• Purpose: OTHER
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants are assigned to learning through either virtual simulation, or team based in situ simulation, and are not planned to cross over during the study period.

Study Record Dates

• First Submitted: December 16, 2021
• First Posted: January 21, 2022
• Study Start: January 1, 2022
• Primary Completion: December 2, 2022
• Study Completion: February 10, 2023
• Last Updated: March 3, 2023

Record last verified: 2023-01

Data Sharing

• IPD Sharing: Will not share

Locations

SG (1)