A Comparison Between Physical and Virtual Simulation: A Randomized Controlled Trial

Not Applicable

Completed

• Conditions: Interdisciplinary Communication
• Interventions: Other: Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)

• Registration Number: NCT04330924
• Lead Sponsor: National University of Singapore

Brief Summary

Nurse-physician communication skills can be improve through inter-professional team training. Simulation is often used to conduct these training. However, constraints to conduct these sessions such as scheduling and logistic arrangements have been widely reported. Thus with the advancement of technology in education, the use of virtual environment to conduct the team training is being explored and evaluated.

Detailed Description

All recruited participants underwent a 3-hour nurse-physician communication training prior to the simulation session. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) curriculum and pre-learning videos were introduced to the participants. Pre-test questionnaires were administered after the training. Participants were then randomized to the control (live simulation) or intervention group (virtual simulation).

Intervention group participants will undergo a virtual simulation session training via the multi-user virtual world by logging in into the 3D virtual environment while participants in the control group performed the simulations in a physical simulated ward setting. Each pair of 1 medical student and 1 nursing student participate in two role-playing simulation scenarios (15-20 minutes each) along with a facilitator who will provide a debrief (30-minutes). Prior to the simulation, participants were given a smart-watch to monitor their physiological parameters such as heart rate. Post-test questionnaires were administered after the simulation sessions.

After the simulation training, a 30-minutes team-based assessments were conducted based on a inter-professional bedside care scenario in pairs of one medical and one nursing student within their randomized group. The assessments were video recorded for evaluation by assessors who are blinded to the groupings. All participants were then invited to complete a follow-up questionnaire 2 months after the simulation training.

Study Timeline

• Study Start: 2018-07-01
• Primary Completion: 2019-12-31
• Study Completion: 2019-12-31
• Study First Submitted: 2020-03-26
• Study First Submitted QC: 2020-03-30
• Status Verified: 2020-04
• Last Update Submitted: 2020-04-01
• Study First Posted: 2020-04-02
• Last Update Posted: 2020-04-03

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

i) Full time students undertaking National University of Singapore's

• Third or fourth year Bachelor of Science (Nursing)
• Third or fourth year Bachelor of Medicine & Bachelor of Surgery

ii) Completed acute care management modules

Exclusion Criteria

i) Does not voluntarily agree to join the study

ii) Does not want their performance to be video-recorded

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Virtual Reality	Create Real-life Experience And Teamwork In Virtual Environment (CREATIVE)	3D avatar in a virtual simulation environment

Primary Outcome Measures

Name	Time	Method
Demographics	Baseline	Collection of participant demographic data.
Pulse rate	Pre-test	Stress measurement parameter using a continuous monitoring smart watch
Blood pressure (diastolic & systolic)	Pre-test	Stress measurement parameter using a sphygmomanometer
Post-test (Change of State-Trait Anxiety Inventory from baseline)	Post-test (immediately after simulation training)	Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Baseline (Confidence and self-efficacy)	Pre-test	Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Communication skill performance	Post-test (immediately after simulation assessment)	Participants nurse-doctor communication skill was measured using a validated team communication scale that was self-developed. It is a 7-item checklist with a 5-point scale. The score ranges from 5 to 35 with higher score indicating better nurse-doctor communication performance.
Baseline (Attitudes Toward Interprofessional Health Care Team)	Pre-test	Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Post-test (Change of Attitudes Toward Interprofessional Health Care Team from baseline)	Post-test (immediately after simulation training)	Measurement of participants' attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Post-test (Change of Interprofessional Socialization and Valuing Scale from baseline)	Post-test (immediately after simulation training)	Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Pulse rate (Change of parameter from baseline)	Post-test (immediately after simulation training)	Stress measurement parameter using a continuous monitoring smart watch
Blood pressure (diastolic & systolic) (Change of parameter from baseline)	Post-test (immediately after simulation training)	Stress measurement parameter using a sphygmomanometer
Baseline (Student Stereotype Rating)	Pre-test	Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high).; The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Follow up (Change of Student Stereotype Rating from baseline and post test)	Follow-up (2-months after simulation training)	Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.
Follow-up (Change of Attitudes Toward Interprofessional Health Care Team from baseline and post-test)	Follow-up (2-months after simulation training)	Measurement of participants attitudes towards working in interprofessional care team using the 14-item Attitudes Toward Interprofessional Health Care Team questionnaire using a 5-point scale. The scores ranges from 14 to 70 with higher score indicating more positive attitudes.
Post-test (Change of Confidence and self-efficacy from baseline)	Post-test (immediately after simulation training)	Measurement of participants confidence and self-efficacy was measured using a 5-items self-efficacy questionnaire through a 10-point likert scale ranging from scores ranging from 5 to 50 with higher score indicating better self-efficacy in their ability in contributing to patient-centered care in a multidisciplinary team.
Baseline (Interprofessional Socialization and Valuing Scale)	Pre-test	Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Follow-up (Change of Interprofessional Socialization and Valuing Scale from baseline and post-test)	Follow-up (2-months after simulation training)	Measurement of participants behaviors, beliefs and attitudes in interprofessional socialization using the 24-item Interprofessional Socialization and Valuing Scale questionnaire using a 7-point scale (1= not at all ; 7= to a very great extent; "not applicable" response is also available). The score ranges from 24 to 168 with higher score indicating greater presence of the attributes measured.
Baseline (State-Trait Anxiety Inventory)	Pre-test	Measurement of participants state anxiety were measured using the 20-items State-Trait Anxiety Inventory questionnaire using a 4 point likert scale (almost never-almost always). The score ranges from 20 to 80 with higher score indicating higher sense of anxiety.
Post test (Change of Student Stereotype Rating from baseline)	Post-test (immediately after simulation training)	Measurement of participants stereotype towards other health disciplines was measured using the 9-items Student Stereotype Rating Questionnaire through a 5-point Likert scale (1=very low to 5= very high). The score ranges from 9 to 45 with higher scores indicating higher perceived ability of the particular healthcare discipline by the other discipline.

Trial Locations

Locations (1)

National University of Singapore; 🇸🇬 Singapore, Singapore