JMIR Publications

ABSTRACT

Background:

Proper donning and doffing of personal protection equipment (PPE) and hand hygiene in the correct spatial context of a health facility is important for the prevention and control of nosocomial infections. On-site training is difficult due to the potential infectious risks and shortages of PPE, whereas video-based training lacks immersion which is vital for the familiarization of the environment. Virtual reality (VR) training can support repeated practice of PPE donning and doffing in an immersive environment that simulates a realistic configuration of a health facility.

Objective:

The aim is to develop and evaluate a VR simulation focusing on the correct order of PPE donning and doffing in an immersive environment that replicates the spatial zoning of a hospital. The VR method should be generic and support customizable sequencing of PPE donning and doffing.

Methods:

An immersive VR PPE training tool was developed by computer scientists and medical experts. The effectiveness of the immersive VR method versus video-based learning was tested in a pilot study as a randomized controlled trial (N=32: VR group N=16, video-based training N=16) using questionnaires on spatial-aware order memorization questions, usability, and task workload. Trajectories of participants in the immersive environment were also recorded for analysis.

Results:

The analysis of the study data showed that the VR group had significantly better usability in the System Usability Scale (VR: \mu=74.78,\ \sigma=13.58 vs. Video: \mu=57.73,\ \sigma=21.13,\ p=0.009) than the video group. Comparable sequence memorization scores (VR: \mu=\ 79.38,\ \sigma=12.90 vs. Video: \mu=74.38,\ \sigma=17.88,\ p=0.372) as well as NASA-TLX scores (VR: \mu=42.9,\ \sigma=13.01 vs. Video: \mu=51.50,\ \sigma=20.44,\ p=0.168) were observed. The analysis and visualization of trajectories revealed a positive correlation between the length of trajectories and the completion time, but neither correlated to the accuracy of the memorization task. Further user feedback indicated a preference for the VR method over the video-based method. Limitations of and suggestions for improvements in the study were also identified.

Conclusions:

A new immersive VR PPE training method was developed and evaluated against the video-based training. Results of the pilot study indicate that the VR method provides comparable training quality to the video-based training with better usability. In addition, the immersive experience of realistic settings and the flexibility of training configurations make the VR method a promising alternative to video instructions. Clinical Trial: Our pilot study was a randomized controlled trial involving University students. It was not a clinical trial and did not involve patients or patient data. Therefore, it was not registered as a clinical trial