• Matthew W Zackoff, Francis J Real, Rashmi D Sahay, Lin Fei, Amy Guiot, Corinne Lehmann, Ken Tegtmeyer, and Melissa Klein.
• Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
• Pediatr Crit Care Me. 2020 May 1; 21 (5): 477-485.

ObjectiveTo determine whether exposure to an immersive virtual reality curriculum on pediatric respiratory distress improves medical students' recognition of impending respiratory failure.DesignRandomized, controlled, prospective study conducted from July 2017 to June 2018. Evaluators blinded to student groupings.SettingAcademic, free-standing children's hospital.ParticipantsAll third-year medical students (n = 168) were eligible. The standard curriculum was delivered to all students during their pediatric rotation with optional inclusion of research data per Institutional Review Board review. A randomized selection of students was exposed to the virtual reality curriculum.InterventionAll students received standard training on respiratory distress through didactics and high-fidelity mannequin simulation. Intervention students underwent an additional 30-minute immersive virtual reality curriculum, experienced through an OculusRift headset, with three simulations of an infant with 1) no distress, 2) respiratory distress, and 3) impending respiratory failure.Measurements And Main ResultsThe impact of the virtual reality curriculum on recognition/interpretation of key examination findings, assignment of an appropriate respiratory status assessment, and recognition of the need for escalation of care for patients in impending respiratory failure was assessed via a free response clinical assessment of video vignettes at the end of the pediatric rotation. Responses were scored on standardized rubrics by physician experts. All eligible students participated (78 intervention and 90 control). Significant differences between intervention and control were demonstrated for consideration/interpretation of mental status (p < 0.01), assignment of the appropriate respiratory status assessment (p < 0.01), and recognition of a need for escalation of care (p = 0.0004).ConclusionsExposure to an immersive virtual reality curriculum led to improvement in objective competence at the assessment of respiratory distress and recognition of the need for escalation of care for patients with signs of impending respiratory failure. This study represents a novel application of immersive virtual reality and suggests that it may be effective for clinical assessment training.

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