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The Feasibility of Virtual Reality and Student-Led Simulation Training as Methods of Lumbar Puncture Instruction

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Abstract

Background

There is limited data assessing simulation and virtual reality training as a standardized tool in medical education. This feasibility study aimed to evaluate the effectiveness of virtual reality training and a student-led simulation module in preparing medical students to perform a lumbar puncture.

Methods

Twenty-five medical students completed a pre-intervention survey, and a baseline video recorded lumbar puncture procedure on a task trainer. Students were randomly distributed into the virtual reality group, or the curriculum’s standard student-led procedural instruction group. Participants were then given 45 min to practice the lumbar puncture procedure. After the intervention, all participants were video recorded again as they performed a post-intervention lumbar puncture and completed a post-intervention survey. Pre- and post-intervention videos were scored using a critical action checklist in conjunction with time needed to complete the procedure to evaluate proficiency.

Results

At baseline, there were no major statistically significant differences between groups. Assessing overall post-intervention performance, both groups showed improvement in aggregate score (p < 0.001) and time required to complete (p = 0.002) the lumbar puncture. Following interventions, the student-led group improved over the virtual reality group in a variety of metrics. The student-led group increased their aggregate score by 3.49 and decreased their time to completion by 34 s over the VR group when controlling for baseline measures.

Conclusions

Both virtual reality and student-led simulation training were useful training modalities, with hands-on simulation showing better results versus virtual reality training in this setting.

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Data Availability

The data generated and analyzed during this study are included in this published article and its supplementary information files. Additional tables reporting the individualized student’s de-identified critical action checklist scores are available from the corresponding author upon reasonable request.

Abbreviations

SBT:

simulation-based training

VR:

virtual reality

OSCE:

objective structured clinical skills

LP:

lumbar puncture

IRB:

institutional review board

UACOM-P:

University of Arizona College of Medicine - Phoenix

SLIPS:

Student Led Independent Procedure Simulations

CAC:

Critical Actions Checklist

CSF:

cerebrospinal fluid

3D:

three-dimensional

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Acknowledgments

The authors wish to thank Arivis and Simulab for their voluntary contributions in physical equipment and employee support which made this study possible. We would also like to give special thanks to the simulation staff at the University of Arizona College of Medicine - Phoenix, as well as the students who were involved in the study.

Funding

There was no external funding for this research project. The simulation trainers from Simulab, VR equipment and technology from Arvis, and physical facilities at the University of Arizona College of Medicine - Phoenix were all provided voluntarily at no charge for the educational advancement of the students.

Author information

Authors and Affiliations

  1. The University of Arizona College of Medicine – Phoenix, 435 N. 5th Street, 4th Floor, Office B420, Phoenix, AZ, USA

    Mark Roehr, Teresa Wu, Philip Maykowski, Bryce Munter, Shelby Hoebee, Eshaan Daas & Paul Kang

  2. Department of Emergency Medicine, Banner University Medical Center – Phoenix, Phoenix, AZ, USA

    Teresa Wu

Authors
  1. Mark Roehr
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  2. Teresa Wu
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  7. Paul Kang
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Contributions

TW and MR developed the original research study design. TW contacted and coordinated with Simulab and Arvis for the physical equipment. MR, TW, PM, BM, and SH assisted with the acquisition of data. PM and PK completed data analysis. MR, PM, BM, and ED drafted the initial manuscript, and all authors were involved in its final revision.

Corresponding author

Correspondence to Mark Roehr.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Approval

This study was reviewed and approved by the University of Arizona Institutional Review Board in January 2018 (Protocol number 1712104316).

Consent to Participate

Written and informed consent was obtained from all participants in the study.

Consent for Publication

All individual details and images contained in this manuscript were consented for use in this project and its publication.

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Supplementary Information

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Roehr, M., Wu, T., Maykowski, P. et al. The Feasibility of Virtual Reality and Student-Led Simulation Training as Methods of Lumbar Puncture Instruction. Med.Sci.Educ. 31, 117–124 (2021). https://doi.org/10.1007/s40670-020-01141-6

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  • DOI: https://doi.org/10.1007/s40670-020-01141-6

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