scholarly journals A different perspective: using interactive virtual reality (IVR) for psychiatry training

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S22-S23
Author(s):  
Huw Evans ◽  
Sophie Young ◽  
Josh Whitehurst ◽  
Abdul Madadi ◽  
Joanne Barton

AimsTo evaluate the potential of interactive virtual reality in teaching and training Postgraduate Psychiatry Trainees in the Keele ClusterBackgroundFace to face supervised clinical experience will always be the best way to train and learn, followed by using simulated patients in practice scenarios allowing a safe environment in which to practice and train without risk. However, the practicalities of a busy NHS often mean that the expense and time required for both of these are not possible and often PowerPoints and handouts in induction are used to prepare new starters in Psychiatry, which is clearly suboptimal. Interactive Virtual Reality (IVR) allows trainees to not only be immersed in a simulation but take control, choosing the direction of questioning for example. It also allows the training to be easily repeated and scaled to any number of students, anytime and anywhere there is an internet connection.MethodFollowing successful funding from the RCPsych General Adult Faculty we chose three common scenarios that a new started in Psychiatry would face. These included acute agitation/rapid tranquilisation, a patient wishing to leave/section 5(2) and a patient with tachycardia following clozapine initiation. Using established guidelines and literature, in conjunction with feedback from subject matter experts and practicing clinicians, scenarios were written. We then researched the best hardware and software to make this possible, ensuring that the resources required were realistic to allow accessibility to as many trainees as possible.ResultCreating IVR is challenging but an engaging medium. Achieving consensus on the training material is time consuming yet paramount to a good training session. Producing high quality videos is extremely resource intensive requiring large amounts of computing power and storage. However, the outcome is an engaging and practical alternative to face to face training.ConclusionThe possibilities for IVR for are vast. For example, trainees can practice different methods of asking questions (e.g. open vs closed) and how this affects the outcome. Training could be produced centrally and then shared, allowing best practice to be disseminated. It could improve and standardise induction, especially considering the expanding workforce. It could also improve recruitment, allowing an immersive experience of Psychiatry to those who would otherwise be unable to obtain shadowing. It also has a role in patient safety – demonstrating common scenarios that the trainee may face allowing them to practice in a safe environment.

Author(s):  
Ashley Pozzolo Coote ◽  
Jane Pimentel

Purpose: Development of valid and reliable outcome tools to document social approaches to aphasia therapy and to determine best practice is imperative. The aim of this study is to determine whether the Conversational Interaction Coding Form (CICF; Pimentel & Algeo, 2009) can be applied reliably to the natural conversation of individuals with aphasia in a group setting. Method: Eleven graduate students participated in this study. During a 90-minute training session, participants reviewed and practiced coding with the CICF. Then participants independently completed the CICF using video recordings of individuals with non-fluent and fluent aphasia participating in an aphasia group. Interobserver reliability was computed using matrices representative of the point-to-point agreement or disagreement between each participant's coding and the authors' coding for each measure. Interobserver reliability was defined as 80% or better agreement for each measure. Results: On the whole, the CICF was not applied reliably to the natural conversation of individuals with aphasia in a group setting. Conclusion: In an extensive review of the turns that had high disagreement across participants, the poor reliability was attributed to inadequate rules and definitions and inexperienced coders. Further research is needed to improve the reliability of this potentially useful clinical tool.


While patient-centered communication supports patient self-care, providers rarely have enough time to consistently use patient- centered communication techniques. Technology has potential to support patient-centered communication, but frequently older adults prefer face-to-face communication with providers. Conversational agents (CAs) may support provider communication with older adults by emulating best practices from face-to-face communication. We investigated older adults’ response to a prototype CA communication system that served as a virtual provider and presented medication instructions using teachback, a recommended best practice that involves asking patients questions to ‘close the communication loop’. Older adults were told how to take medications by a CA who used (or did not use) teachback, and then were interviewed. Older adults were open to interacting with the CA and thought it would help support self-care. They thought the CA was a more effective teacher when using teachback and that this interactive strategy helped them remember the instructions. However, teachback did not improve instruction memory.


2021 ◽  
pp. e20210043
Author(s):  
Sarah Baillie ◽  
Annelies Decloedt ◽  
Molly Frendo Londgren

Flipped classroom is an educational technique in which content is delivered online for students to study at their own pace in preparation for in-class learning. Benefits include increased flexibility, enhanced student engagement and satisfaction, and more effective use of time spent during face-to-face teaching. However, the development and implementation of flipped classroom teaching are also associated with challenges, including time required to develop learning materials and getting students to engage with the preparatory work. This teaching tip describes a structured approach to designing and implementing the flipped classroom approach for clinical skills to allow a greater focus on practicing the hands-on skills and the provision of feedback during the laboratory session. First, the rationale for flipping the classroom and the expected benefits should be considered. On a practical level, decisions need to be made about what to include in the flipped component, how it will complement the face-to-face class, and how the resources will be created. In the design phase, adopting a structured template and aligning with established pedagogical principles is helpful. A well-designed flipped classroom motivates learners by including different elements such as quality educational media (e.g., videos), the opportunity to self-assess, and well-defined connections to relevant knowledge and skills. Student engagement with the flipped material can be promoted through different strategies such as clear communication to manage student expectations and adapting the delivery of the face-to-face component. Finally, gathering feedback and evaluating the initiative are important to inform future improvements.


2021 ◽  
Vol 104 (Suppl. 1) ◽  
pp. S30-S34

Background: Although peripheral Intravenous (IV) cannulation is a routine procedure performed by nurses, IV access can be difficult to achieve, particularly in emergency patients who have critical illnesses. Ultrasound is used in this procedure to increase the success rate in novice practitioners. Objective: We aimed to determine the first-attempt success rate of ultrasound-guided peripheral IV (USGPIV) performed by emergency nurses in simulation model after having undergone training in the procedure. Materials and Methods: This was prospective descriptive study. The participants consisted of 61 emergency nurses at Srinagarind Hospital Emergency Department from January to April 2020. USGPIV cannulation training was provided by an emergency physician who is also a specialist in emergency ultrasound. After training, we calculated the number of attempts and time required to successfully complete USGPIV in a simulation model. Following this, participants responded to a questionnaire to evaluate their confidence in performing the procedure, as well as its feasibility and practical application. Data were analyzed using a Kolmogorov-Smirnov test, and p<0.05 was considered to be significant. Results: Sixty-one emergency nurses were included. The first-attempt success rate of USGPIV was 85.25% (95% CI 0.761, 0.944), and the mean time required was 47.33+4.89 sec. (95% CI 37.547, 57.103). Fifty-nine participants (96.72%) completed the questionnaire. All items had a mean score of greater than 3 points, with confidence score being the highest. Conclusion: Emergency nurses with no previous experience with USGPIV were able to perform a simulated version of the procedure with a high first-attempt success rate after a short training session. Further studies should be conducted to evaluate nurses’ USGPIV competency in real patients. Keywords: Ultrasound, Peripheral IV cannulation, Emergency medicine, Emergency nurse


Author(s):  
Ibrahim Darwich ◽  
Mohammad Abuassi ◽  
Christel Weiss ◽  
Dietmar Stephan ◽  
Frank Willeke

Purpose: The advent of robotic surgery has highlighted the advantages of articulation. This dry-lab study examined the dexterity and learning effect of a new articulated laparoscopic instrument: the ArtiSential® forceps (LIVSMED, Seongnam, Republic of Korea). Methods: A peg board task was designed. Three groups of volunteers with varying levels of laparoscopic expertise were organized to perform the task: expert, intermediate and novice. The participants performed the task using articulated and straight instruments, once before a 30-min training session and once afterwards. The times required to perform the task were recorded. The performances were analyzed and compared between the groups as well as between the straight and articulated instruments. Results: The experts were significantly faster than the novices with both instruments before the 30-min training session (p = 0.0317 for each instrument). No significant time difference was found among the three groups after the 30-min training session. The decrease in the time required to perform the peg-transfer task with the articulated instrument was significantly greater in the novice and intermediate groups (p = 0.0159 for each group). No significant difference in time reduction was observed between the groups with the straight instrument. Regardless of the user, the articulated device was associated with faster task performance than the straight device after 8 hours of training (p = 0.0039). Conclusion: The ArtiSential® articulated device can improve dexterity. A significantly greater learning effect was observed in the novice and intermediate groups in comparison with experts. A plateau in the learning curve was observed after a few hours of training.


2021 ◽  
Vol 2 ◽  
Author(s):  
Yilu Sun ◽  
Andrea Stevenson Won

The ability to perceive emotional states is a critical part of social interactions, shaping how people understand and respond to each other. In face-to-face communication, people perceive others’ emotions through observing their appearance and behavior. In virtual reality, how appearance and behavior are rendered must be designed. In this study, we asked whether people conversing in immersive virtual reality (VR) would perceive emotion more accurately depending on whether they and their partner were represented by realistic or abstract avatars. In both cases, participants got similar information about the tracked movement of their partners’ heads and hands, though how this information was expressed varied. We collected participants’ self-reported emotional state ratings of themselves and their ratings of their conversational partners’ emotional states after a conversation in VR. Participants’ ratings of their partners’ emotional states correlated to their partners’ self-reported ratings regardless of which of the avatar conditions they experienced. We then explored how these states were reflected in their nonverbal behavior, using a dyadic measure of nonverbal behavior (proximity between conversational partners) and an individual measure (expansiveness of gesture). We discuss how this relates to measures of social presence and social closeness.


BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S149-S149
Author(s):  
Zoe Moore ◽  
Linda Irwin ◽  
Stuart Brown ◽  
Julie Anderson ◽  
Stephen Moore

AimsOur aim was to establish a Peer Mentoring Network within Psychiatry Training in Northern Ireland.Recognising that starting a new job can be a stressful time in any junior doctor's career, we wanted to ensure that new Core Trainees (CT1s) joining our Specialty Programme were well supported through this transition.Although Clinical and Educational Supervision is well established in providing a support structure for trainees, we believed that a peer mentoring relationship, (with allocation of a Higher Psychiatry Trainee as mentor), would be of additional benefit.It was hoped that the scheme would prove mutually beneficial to both mentee and mentor.MethodWe delivered a presentation at CT1 induction and sent out follow-up emails to encourage participation. Higher trainees were also sent information via email and asked to complete a basic application form if interested in becoming a mentor. Prospective mentors then attended a one-day training session.Two lead mentors, (also higher trainees), were allocated to oversee the scheme, with additional supervision from two lead Consultants. Mentor-Mentee matches were made based on information such as location, sub-specialty affiliations and outside interests.Matched pairs were advised about the intended frequency and nature of contacts. Check-in emails were sent halfway through the year and feedback evaluations completed at the end.Result95% of trainees who completed the evaluations said they would recommend the scheme to colleagues.Mentees reported benefits in terms of personal and professional development, whilst mentors reported improved listening, coaching, and supervisory skills.A small number of trainees highlighted that 6 monthly rotations impacted on ability to maintain face to face contacts.Recruitment and engagement have improved annually. We are currently running the third year of the scheme and have achieved 100% uptake amongst CT1s and are over-subscribed with mentors, (19 mentors to 13 mentees).ConclusionThe majority of feedback received has been positive and interest in the scheme continues to grow.Potential issues relating to location of postings has been overcome, at least in part, by recent changes to ways of working and the use of alternative forms of contact, such as video calling.Having exceeded demand in terms of mentor recruitment, we hope to extend the scheme to include trainees of other grades, and particularly those who are new to Northern Ireland.We are excited to see where the next stage of our journey takes us and hope that others will be inspired to embark on similar schemes within their areas of work.


Sign in / Sign up

Export Citation Format

Share Document