529 - Teaching the Pediatric Assessment Triangle: is Virtual Reality better than Lecture?

Poster Number: 529
Publication Number: 529.327

Patricia L. Camino, Maimonides Infants and Children's Hospital of Brooklyn, BROOKLYN, NY, United States; Saxony Busta, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Shannon Kostin, Maimonides Infants and Children's Hospital of Brooklyn, Staten Island, CT, United States; Shaughn Head, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Kevin Chan, Maimonides Medical Center, Brooklyn, NY, United States; Eric Roseman, Maimonides Medical Center, Brooklyn, NY, United States; Michele J. Fagan, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States; Amish Aghera, Maimonides Infants and Children's Hospital of Brooklyn, Brooklyn, NY, United States

Background: Virtual Reality (VR) using headsets to create a fully immersive learning environment has the potential to improve learning by improving interactivity and engaging learners in an experiential process. There is a slowly emerging body of evidence that suggests it can be useful, but it’s still unclear as to what areas VR may be best suited for, and what level of immersion further enhances learning.

Objective: The objective of this study is to compare two approaches to teaching and evaluating the Pediatric Assessment Triangle (PAT), a widely recognized component of PALS used to rapidly assess critically ill children. PAT is traditionally taught in lecture format utilizing videos and pictures to demonstrate a spectrum of severity of illness, but VR significantly enhances fidelity through more realistic imagery and immersion.

Design/Methods: This was a randomized controlled study involving Emergency Medicine (EM) and Pediatric (Peds) interns during orientation, from an urban academic center where both programs are ACGME accredited. Interns were randomly assigned into either VR or lecture. The VR module was developed by a software vendor (Health Scholars) and the lecture was a recorded video created and delivered by a Ped Intensivist. Upon completion, interns underwent a short assessment using videos of both stable and sick patients. Scores were based upon the ability to correctly categorize patients based on elements of the PAT, yielding a total correct percent. Content validity of the exam was supported by review and response process was supported through sample testing by senior Peds and Peds EM faculty. Descriptive statistics and a comparison of medians via Wilcoxon Mann Whitney (WMW) test were used to analyze data.

Results: A total of 36 interns were enrolled in the study, with 18 in each group (9 EM, 9 Peds). Interns scored a mean of 56.7% (SD 15%), median 50% after VR and 55.2% (SD 12%) and 54.7% after lecture respectively. The WMW comparison of medians showed no statistical difference in assessment scores between both groups (p value of 0.899).

Conclusion(s): Our initial results suggest that interns achieve similar post-module scores whether they underwent PAT training via VR or traditional lecture. Neither groups’ assessment scores suggested adequate performance after an initial training. VR might be better suited as a method for ongoing deliberate practice rather than initial learning, but this needs additional investigation.