A comparative study of video lecture versus video lecture and high fidelity simulation for training nurses on the delivery of targeted temperature management after cardiac arrest.

INTRODUCTION: Targeted temperature management (TTM) is recommended for cardiac arrest patients. Successful implementation of a TTM protocol depends on the nurses' knowledge and skills. The study's aim was to compare the level of knowledge, psychomotor skills, confidence and satisfaction before, immediately after and at 6 weeks after training nurses on the delivery of TTM with video lecture versus video lecture and high fidelity simulation. METHOD: Demographic variables were compared across treatment groups using t-tests and Chi-square tests. Change over 6 weeks after intervention was tested with mixed effects model. RESULTS: Fifty-two registered nurses were enrolled. Knowledge test scores, the primary outcome, did not differ between the groups immediately after the training (beta = 3.80, SE = 3.47, p = .27), but there was a strong trend 6 weeks after the training in favor of simulation (beta = 7.93, SE = 3.88, p = .04). Skills were significantly better immediately after the training in the simulation group, but no different 6 weeks later. No difference in confidence was found at either post-test point. Simulation-trained nurses were more satisfied with their training at both post-testing points. CONCLUSION: In this study of training approaches to TTM after cardiac arrest, nurses trained with video lecture and high fidelity simulation benefitted from this approach by maintaining their TTM knowledge longer.

A pilot study to compare virtual reality to hybrid simulation for opioid-related overdose and naloxone training.

BACKGROUND: In the midst of the international opioid-related overdose (OOD) crisis, appropriate naloxone training is needed by both healthcare professionals and community members to better leverage its life-saving potential. OBJECTIVE: Pilot the use of a virtual reality simulation for training student nurses to identify signs and symptoms of an OOD, properly administer intranasal naloxone, and provide immediate recovery care after revival. DESIGN: This quasi-experimental pretest-posttest study evaluated knowledge and attitudes towards intervening during an opioid-related overdose among student nurses before and after participating in a traditional hybrid simulation or virtual reality simulation. SETTING: A medium sized urban university's school of nursing in the Northeastern United States. PARTICIPANTS: Fifty (N = 50) senior Bachelor of Nursing Science (BSN) students. METHODS: Knowledge and attitudes were assessed using the Opioid Overdose Knowledge Scale (OOKS) and Opioid Overdose Attitudes Scale (OOAS). Students completed measures 3 weeks prior to training and 3 weeks after. Appropriate t-tests evaluated changes in OOAS and OOKS scores both within and between training groups (e.g. hybrid simulation compared to virtual reality). RESULTS: Sample characteristics were well balanced in both the hybrid simulation group (n = 31) and virtual reality group (n = 19). There were no statistically significant differences in average OOKS and OOAS scores at baseline or at follow up between those receiving hybrid simulation or the virtual reality training. All participants' attitudes scores decreased from baseline to follow up by <2 points. However, there was no difference in the change in knowledge scores between the training groups. CONCLUSIONS: Individuals participating in the virtual reality simulation had similar knowledge retention and attitudes towards responding during an opioid-related overdose and administering intranasal naloxone when compared to individuals participating in hybrid simulation. The lack of significant findings between training groups indicates that the mobile virtual reality training is comparable to the in-person hybrid simulation for training nursing students to appropriately administer naloxone to reverse OOD and provide immediate recovery care after revival.

Leveraging immersive technology to expand access to opioid overdose reversal training in community settings: Results from a randomized controlled equivalence trial.

BACKGROUND: Immersive video (e.g. virtual reality) poses a promising and engaging alternative to standard in-person trainings and can potentially increase access to evidence-based opioid overdose prevention programs (OOPPs). Therefore, the objective of this equivalence study was to test whether the immersive video OOPP was equivalent to a standard in-person OOPP for changes in opioid overdose knowledge and attitudes. METHODS: A team of nurses and communication researchers developed a 9-minute immersive video OOPP. To test whether this immersive video OOPP (treatment) demonstrated equivalent gains in opioid overdose response knowledge and attitudes as in-person OOPPs (standard of care control), researchers deployed a two-day field experiment in Philadelphia, Pennsylvania, USA. In this equivalence trial, 9 libraries were randomly assigned to offer treatment or control OOPP to community members attending naloxone giveaway events. In this equivalence design, a difference between treatment and control groups pre- to post-training scores within -1.0 to 1.0 supports equivalence between the trainings. RESULTS: Results demonstrate participants (N = 94) exposed to the immersive video OOPP had equivalent improvements on posttest knowledge (ß=-0.18, p = .61) and more favorable attitudes about responding to an opioid overdose (ß=0.26, p = .02) than those exposed to the standard OOPP. However, these minor differences in knowledge and attitudes were within the equivalence interval indicating that the immersive video OOPP remained equivalently effective for community members. CONCLUSIONS: Community partnerships, like those between public health departments and libraries, can provide opportunities for deploying novel immersive video OOPP that, alongside standard offerings, can strengthen community response to the opioid crisis.