How, for Whom, and in Which Contexts or Conditions Augmented and Virtual Reality Training Works in Upskilling Health Care Workers: Realist Synthesis

BACKGROUND: Using traditional simulators (eg, cadavers, animals, or actors) to upskill health workers is becoming less common because of ethical issues, commitment to patient safety, and cost and resource restrictions. Virtual reality (VR) and augmented reality (AR) may help to overcome these barriers. However, their effectiveness is often contested and poorly understood and warrants further investigation. OBJECTIVE: The aim of this review is to develop, test, and refine an evidence-informed program theory on how, for whom, and to what extent training using AR or VR works for upskilling health care workers and to understand what facilitates or constrains their implementation and maintenance. METHODS: We conducted a realist synthesis using the following 3-step process: theory elicitation, theory testing, and theory refinement. We first searched 7 databases and 11 practitioner journals for literature on AR or VR used to train health care staff. In total, 80 papers were identified, and information regarding context-mechanism-outcome (CMO) was extracted. We conducted a narrative synthesis to form an initial program theory comprising of CMO configurations. To refine and test this theory, we identified empirical studies through a second search of the same databases used in the first search. We used the Mixed Methods Appraisal Tool to assess the quality of the studies and to determine our confidence in each CMO configuration. RESULTS: Of the 41 CMO configurations identified, we had moderate to high confidence in 9 (22%) based on 46 empirical studies reporting on VR, AR, or mixed simulation training programs. These stated that realistic (high-fidelity) simulations trigger perceptions of realism, easier visualization of patient anatomy, and an interactive experience, which result in increased learner satisfaction and more effective learning. Immersive VR or AR engages learners in deep immersion and improves learning and skill performance. When transferable skills and knowledge are taught using VR or AR, skills are enhanced and practiced in a safe environment, leading to knowledge and skill transfer to clinical practice. Finally, for novices, VR or AR enables repeated practice, resulting in technical proficiency, skill acquisition, and improved performance. The most common barriers to implementation were up-front costs, negative attitudes and experiences (ie, cybersickness), developmental and logistical considerations, and the complexity of creating a curriculum. Facilitating factors included decreasing costs through commercialization, increasing the cost-effectiveness of training, a cultural shift toward acceptance, access to training, and leadership and collaboration. CONCLUSIONS: Technical and nontechnical skills training programs using AR or VR for health care staff may trigger perceptions of realism and deep immersion and enable easier visualization, interactivity, enhanced skills, and repeated practice in a safe environment. This may improve skills and increase learning, knowledge, and learner satisfaction. The future testing of these mechanisms using hypothesis-driven approaches is required. Research is also required to explore implementation considerations

The Development of Research Skills in Nursing Postgraduate Training

Funding: This research was funded by the Lisbon Center for Nursing Research, Innovation and Development (CIDNUR) and the POCTEP 4IE+ Project.Abstract: The objective of this study was to understand the contribution of postgraduate training to the development of research skills, aiming at their application in clinical practice. Method: This was a qualitative, exploratory, and descriptive study conducted with eight nurses in the Local Health Unit of Baixo Alentejo, in Portugal, who had postgraduate training. The researchers conducted a group interview, or discussion group, using a semi-structured interview, which was assessed by two reviewers. The data were submitted to content analysis, and the results underwent a validation process with the participants and two reviewers. This study was approved by the institution’s ethics committee. Result: In terms of the research skills developed in nursing postgraduate education, the following indicators emerged from the participants’ discourse: understanding the research process, searching databases, developing literature reviews, assessing the quality of articles, developing research projects, communicating about science, and translating knowledge into clinical practice. Conclusion: The participants developed research skills in their nursing postgraduate training and reported developing these skills in their clinical practice.info:eu-repo/semantics/publishedVersio

Implementation of Virtual Reality (VR) simulators in Norwegian maritime pilotage training

With millions of tons of cargo transported to and from Norwegian ports every year, the maritime waterways in Norway are heavily used. The high consequences of accidents and mishaps require well-trained seafarers and safe operating practices. The normal crews of vessels are supported by the Norwegian Coastal Administration (NCA) pilot service when operating vessels not meeting specific regulations. Simulator training is used as part of the toolset designed to educate, train, and advance the knowledge of maritime pilots in order to improve their operability. The NCA is working on an internal project to distribute Virtual Reality (VR) simulators to selected pilot stations along the coast and train and familiarize maritime pilots with the tool. There has been a lack of research on virtual reality simulators and how they are implemented in maritime organizations. The goal of this research is to see if a VR-simulator can be used as a training tool within the Norwegian Coastal Administration's pilot service. Furthermore, the findings of this study contribute to the understanding of VR-simulators in the field of Maritime Education and Training (MET). The thesis is addressing two research questions: 1. Is the Virtual Reality training useful in the competence development process of Norwegian maritime pilots? 2. How can the Virtual Reality simulators improve training outcomes of today’s maritime pilot education? The data gathered from the systematic literature review corresponds to the findings of the interviews. Considering the similarities with previous study findings from sectors such as healthcare, construction, and education, it is concluded that the results of the interviews can be generalized. For maritime pilots, the simulator offers recurrent scenario-based training and a high level of immersion. Pilots can learn at home, onboard a vessel, at the pilot station, and in group settings thanks to the system's mobility and user-friendliness. In terms of motivation and training effectiveness, the study finds that VR-simulators are effective and beneficial. The technology received positive reviews from the pilots. The simulator can be used to teach both novice and experienced maritime pilots about new operations, larger tonnage, and new operational areas, according to the findings of the research. After the NCA has utilized VR-simulators for some time, additional research may analyze the success of VR-simulators using a training evaluation study and investigate the impact of VR-training in the organization

A scoping review

Funding Information: This work was supported by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil; and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil. Publisher Copyright: © 2023 Elsevier LtdBackground: Even though clinical practice is crucial for nursing students' personal and professional development, it is recurrently associated with stress. However, stressful situations may not only elicit negative responses, but positive responses as well, and such aspects should be further investigated. Aim: To explore the literature addressing the positive and negative aspects of stress experienced by nursing students during clinical practicum. Design: This scoping review followed the Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. Data sources: CINAHL, MEDLINE/PubMed, PsycINFO, Web of Science, IBECS, LILACS, BDENF and two theses and dissertations repositories. Review methods: Searches were conducted from June to August 2022. Studies addressing the positive and negative aspects of stress experienced by nursing students during clinical practice were included regardless of the method adopted. Results: This review included 32 studies published between 1999 and 2022 in 25 countries across four continents: Africa, America, Asia, and Europe. Stress can positively influence academic performance, especially in mobilizing a search for learning and professional development and in integrating theoretical knowledge and improving clinical skills and competencies. Negatively, stress can cause biopsychosocial symptoms that compromise a student's academic performance and can cause doubts and uncertainties about the construction of their professional identity. Conclusions: Although the negative aspects stand out over the positive ones, it is evident that both are present in the clinical practice environment. When considering stress of nursing students, educators should conduct the teaching-learning process in order to reduce the negative impact and promote the positive side of stressful situations.publishersversionpublishe

Augmented Reality and Health Informatics: A Study based on Bibliometric and Content Analysis of Scholarly Communication and Social Media

Healthcare outcomes have been shown to improve when technology is used as part of patient care. Health Informatics (HI) is a multidisciplinary study of the design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning. Augmented Reality (AR) is an emerging technology that enhances the user’s perception and interaction with the real world. This study aims to illuminate the intersection of the field of AR and HI. The domains of AR and HI by themselves are areas of significant research. However, there is a scarcity of research on augmented reality as it applies to health informatics. Given both scholarly research and social media communication having contributed to the domains of AR and HI, research methodologies of bibliometric and content analysis on scholarly research and social media communication were employed to investigate the salient features and research fronts of the field. The study used Scopus data (7360 scholarly publications) to identify the bibliometric features and to perform content analysis of the identified research. The Altmetric database (an aggregator of data sources) was used to determine the social media communication for this field. The findings from this study included Publication Volumes, Top Authors, Affiliations, Subject Areas and Geographical Locations from scholarly publications as well as from a social media perspective. The highest cited 200 documents were used to determine the research fronts in scholarly publications. Content Analysis techniques were employed on the publication abstracts as a secondary technique to determine the research themes of the field. The study found the research frontiers in the scholarly communication included emerging AR technologies such as tracking and computer vision along with Surgical and Learning applications. There was a commonality between social media and scholarly communication themes from an applications perspective. In addition, social media themes included applications of AR in Healthcare Delivery, Clinical Studies and Mental Disorders. Europe as a geographic region dominates the research field with 50% of the articles and North America and Asia tie for second with 20% each. Publication volumes show a steep upward slope indicating continued research. Social Media communication is still in its infancy in terms of data extraction, however aggregators like Altmetric are helping to enhance the outcomes. The findings from the study revealed that the frontier research in AR has made an impact in the surgical and learning applications of HI and has the potential for other applications as new technologies are adopted

Data Mining; A Conceptual Overview

This tutorial provides an overview of the data mining process. The tutorial also provides a basic understanding of how to plan, evaluate and successfully refine a data mining project, particularly in terms of model building and model evaluation. Methodological considerations are discussed and illustrated. After explaining the nature of data mining and its importance in business, the tutorial describes the underlying machine learning and statistical techniques involved. It describes the CRISP-DM standard now being used in industry as the standard for a technology-neutral data mining process model. The paper concludes with a major illustration of the data mining process methodology and the unsolved problems that offer opportunities for research. The approach is both practical and conceptually sound in order to be useful to both academics and practitioners

Surgical Data Science - from Concepts toward Clinical Translation

Recent developments in data science in general and machine learning in particular have transformed the way experts envision the future of surgery. Surgical Data Science (SDS) is a new research field that aims to improve the quality of interventional healthcare through the capture, organization, analysis and modeling of data. While an increasing number of data-driven approaches and clinical applications have been studied in the fields of radiological and clinical data science, translational success stories are still lacking in surgery. In this publication, we shed light on the underlying reasons and provide a roadmap for future advances in the field. Based on an international workshop involving leading researchers in the field of SDS, we review current practice, key achievements and initiatives as well as available standards and tools for a number of topics relevant to the field, namely (1) infrastructure for data acquisition, storage and access in the presence of regulatory constraints, (2) data annotation and sharing and (3) data analytics. We further complement this technical perspective with (4) a review of currently available SDS products and the translational progress from academia and (5) a roadmap for faster clinical translation and exploitation of the full potential of SDS, based on an international multi-round Delphi process

Virtual Reality Technologies in Health Care: A Literature Review of Theoretical Foundations

The digitization of health care promises an improvement of medical care through the adoption of virtual reality (VR) related technologies. Although most undergoing mechanisms of clinical effectiveness are yet not defined theoretically, research approaches have already taken place in several empirical settings. To structure current and upcoming scientific work in this field, we conducted a literature review with regard to theoretical implications of both IS-related and healthcare-related research. We found several theoretical bases to build upon in the field of psychology, but expressed a need for enrichment of theoretical foundations in the field of IS research. We therefore plead for a theoretical foundation enriched by synergetic concepts of clinically effective VR related technologies. Finally, we conclude that VR related technologies appear as a promising approach worth further theoretical and empirical research in order to improve medical care