JMIR Publications

ABSTRACT

Background:

Cardiac arrest after cardiac surgery commonly has a reversible cause, where emergency resternotomy is often required for treatment, as recommended by international guidelines. We have developed a virtual reality (VR) simulation for training of cardiopulmonary resuscitation (CPR) and emergency resternotomy procedures after cardiac surgery, the CardioPulmonary resuscitation VR-simulator (CPVR-sim). Two fictive clinical scenarios were used; one case of Pulseless Electrical Activity (PEA) and a combined case of PEA and Ventricular Fibrillation (VF). In this prospective study, we researched face validity and content validity of this CPVR-sim.

Objective:

We designed a prospective study to assess the feasibility and to establish the face and content validity of two clinical scenarios (shockable and non-shockable cardiac arrest) of a CPVR-sim partly divided in a group of novices and experts in performing CPR and emergency resternotomies in patients after cardiac surgery.

Methods:

Clinicians (staff cardiothoracic surgeons, physicians, surgical residents, nurse practitioners, and medical students) participated in this study and performed two different scenarios, either PEA or combined PEA and VF. All participants (N=41) performed a simulation and completed the questionnaire rating the simulator’s usefulness, satisfaction, ease of use, effectiveness, and immersiveness to assess face validity and content validity.

Results:

Responses towards face validity and content validity were predominantly positive in both groups. Most participants in the PEA scenario (n=26, 87%) felt actively involved in the simulation and 23 participants (77%) felt in charge of the situation. The participants thought it was easy to learn how to interact with the software (n=24, 80%), and thought that the software responded adequately (n=21, 70%). All 15 expert-participants (100%) preferred VR training as an addition to conventional training. Moreover, 13 (87%) of the expert-participants would recommend VR training to other colleagues, and 14 (93%) of the expert-participants thought that CPVR-sim is a useful method to train for infrequent post-cardiac surgery emergencies requiring CPR. Also, 10 (91%) of the participants thought it was easy to move in the VR environment, and that the CPVR-sim responded adequately in this scenario.

Conclusions:

We developed a proof-of-concept of a VR simulation for CPR training with two scenarios of a patient after cardiac surgery, which participants found was immersive and useful. By proving the face validity and content validity of CPVR-sim, we present a first step towards a cardiothoracic surgery VR training platform.