Virtual reality as an engaging and enjoyable method for delivering emergency clinical simulation training: a prospective, interventional study of medical undergraduates.

BACKGROUND: It is a requirement that medical students are educated in emergencies and feel well prepared for practice as a doctor, yet national surveys show that many students feel underprepared. Virtual reality (VR), combined with 360-degree filming, provides an immersive, realistic, and interactive simulation experience. Unlike conventional in-person simulation, it is scalable with reduced workforce demands. We sought to compare students' engagement and enjoyment of VR simulation to desktop computer-based simulation. METHODS: We conducted a prospective, interventional, evaluation study. The study was carried out on final year medical students undertaking their Pre-Foundation Assistantship (n = 116) at Imperial College School of Medicine (ICSM) in London. We compared objective engagement, subjective engagement, and subjective enjoyment of VR simulation to desktop computer-based simulation using cardiac arrest and life-threatening asthma scenarios. Engagement was measured objectively using students' physiological parameters, including heart rate and eye tracking, and facilitator observations using the validated 'Behavioural Engagement Related to Instruction' (BERI) protocol. Students' subjective engagement and enjoyment levels were measured using a post-session survey. RESULTS: Students' maximum heart rates were significantly higher during VR simulation with a mean difference of 4.2 beats per minute (3.2 to 5.2, p < 0.001), and eye tracking showed they spent a significantly greater mean percentage of time of 6.4% (5.1 to 7.7, p < 0.001) focusing on the scenarios in VR compared to standard desktop. Qualitative data showed students enjoyed and felt engaged with the sessions, which provided a safe space for learning. CONCLUSIONS: Our study shows that students found VR simulations enjoyable and were more engaged compared to standard desktop simulation. This suggests that 360-degree VR simulation experiences provide students with immersive, realistic training, which is scalable, giving them the unique opportunity to manage emergencies and work within emergency teams, which would not typically occur during traditional training.

Improving international medical graduates' understanding of the UK appraisal system: an interventional study.

International medical graduates (IMGs) face countless challenges when migrating to a new healthcare system, of which understanding the UK appraisal and revalidation system is one. We investigated whether provision of educational material on appraisals would improve IMGs' confidence in their understanding of the UK appraisal system. A prospective pre-post interventional study aimed at IMGs was carried out between 25 February 2022 and 9 March 2022. A mixed-methods survey was undertaken pre (n=519) and post (n=63) intervention. The pre-interventional survey highlighted IMGs' lack of experience and knowledge of the General Medical Council (GMC) appraisal and revalidation process. Postinterventional responses showed a significantly higher confidence rating in IMGs' understanding of the UK appraisal process (p<0.001). Utilising simple educational tools can be beneficial for IMGs to gain confidence in navigating appraisals and help bridge the attainment gap when entering a new healthcare system. Barriers, such as lack of knowledge, can be easily rectified without the need for significant investment.