| BackgroundCardiac arrest is one of the leading causes of death in the most parts of the world.Cardiopulmonary resuscitation(CPR)is an effective measure to improve the survival rate of patients with cardiac arrest.It is also a basic skill that all medical staff must master.Improving the CPR level of medical students is of great significance for improving the overall CPR level of medical staff.However,due to the limitation of current CPR training methods and the uncertain retraining time of CPR,the level of CPR knowledge and skills of medical students in China is not ideal.With the development of simulations,many teaching methods have been widely used in CPR training.The emergence of virtual reality(VR)technology expands the method of simulations and provides a new possibility of CPR training.In recent years,smart phone applications(apps),which are based on VR technology,have been used for CPR training by foreign researchers.However,it is not clear whether there is an appropriate CPR training app in China.How many and which app might be helpful is still unknown,and there is no research report on the application of VR technology to CPR training.Objectives1.To evaluate the quality of CPR training apps based on VR technology in China,in order to select appropriate training tools;2.To discuss the feasibility of VR training for CPR;3.To explore the effect of CPR training for medical students via VR and the maintenance time of CPR knowledge and skills for medical students after VR training to clarify the retraining time.MethodsPart I:Screening and evaluation of training tools for CPRFive brands of smart phones with the largest number of users in China were selected.Eighteen search terms of apps were inputted in the app mall of mobile phones,respectively.CPR training apps,which were based on VR technology,were screened out.From July 2017 to February 2018,a convenience sample of five physicians,five nurses and 10 interns from the cardiovascular medicine department of a tertiary hospital in Guangzhou were selected as evaluators.The correctness and usability of the selected app were evaluated by using self-designed app content evaluation checklist and the system usability scale(SUS).Part II:The effect of applying VR technology to train medical students for CPRA convenience sample of 71 students majoring in clinical medicine was recruited from a Medical University in Guangzhou and randomly divided into two groups,from May 2018 to November 2018.The CPR knowledge level of the students was investigated before the training.After the CPR knowledge was taught in two groups,VR technology and scenario simulation method were used to train the CPR skills of students,respectively.The skills training tool of VR group was "Lifesaver VR",a CPR training app designed by Resuscitation Council UK.Based on VR technology,the app simulates a scene that a teenager has sudden cardiac arrest at home.After wearing VR equipment,trainees will learn how to implement CPR step by step according to instruction of the app.The CPR knowledge and skill level of students were assessed immediately,1 month and 6 months after training.A self-designed knowledge test paper was used for knowledge assessment,which consisted of 15 single-choice questions with a total score of 15 points.The CPR skill level of trainees was evaluated with the skill assessment checklist of standardized teaching documents,which was made by Guangdong Committee of Red Cross.The checklist included 17 items with a total score of 43 points.Four items were key items.They were chest compression position,chest compression rate,chest compression depth and full chest wall recoil.The total scores of knowledge and skill assessment were converted into 100 points.ResultsPart Ⅰ:Screening and evaluation of training tools for CPRA total of 4318 apps were searched.Only one app met the inclusion criteria and was included in the evaluation process.The app is called "Lifesaver VR".Its content correctness is very high,with an average score of 17.4± 0.7.It is easy to learn and can be accepted by users,the average score of SUS is 68.1± 16,9.Part Ⅱ:The effect of applying VR technology to train medical students for CPR1.CPR knowledgeThe total knowledge scores of VR group students before training,immediately after training,1 month and 6 months later were 48.4± 9.6,88.9± 5.3,87.6± 6.2,82.4± 6.9.The total scores of scenario simulation group students were 46.4 ±7.1,88.2± 4.9,86.0±8.5,80.4±8.7,respectively.There were no significant differences in scores between the two groups at each time(P>0.05),but the scores after training were all higher than those before training(P<0.05).2.CPR SkillsThe total scores of skills in VR group were higher than that in scenario simulation group immediately,1 month and 6 months after training(95.4± 4.3 vs 83.9± 6.4,92.3± 7.8 vs 82.8±7.6,87.1± 10.3 vs 81.6± 9.2).There were significant differences between the two groups at each time(P<0.05).Only the score of 6 months after training in VR group was significantly different from that of immediately after training and 1 month after training(P<0.05).Immediately after training,1 month and 6 months later,the total scores of key items in VR group were higher than that in scenario simulation group(19.5±0.7 vs 16.1±2.4,18.9± 1.5 vs 16.0±3.1,18.3± 2.2 vs 15.6±3.4).There were significant differences between the two groups at each time(P<0.05).And only the score of 6 months after training in VR group was significantly different from that of immediately after training(P<0.05).ConclusionsThere are few CPR training app based on VR technology,so it is necessary to develop high-quality CPR training app according to the characteristics of different trainees;VR training is feasible,which provides new methods for CPR training;VR training significantly improves CPR knowledge and skills of medical students and promotes students to master high-quality CPR;6 months after VR training,students’knowledge and skills declined significantly.It is suggested that the time for retraining after VR training should not exceed 6 months. |
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