P74 The DEVICE project: diabetes emergencies: virtual interactive clinical education

Field: Health Professions (Health Sciences)

Background

The TOPDOC survey reported low confidence in Diabetes Mellitus (DM) management by non-diabetes specialist doctors.¹ The prevalence of Type 1 diabetes is increasing and there is a national awareness of increased risk of Diabetic Ketoacidosis (DKA) in hospital with Type 1 diabetes. DM is becoming increasingly complex as patients are living longer with multiple comorbidities and polypharmacy. Virtual reality (VR) simulation has been used in training successfully in multiple industries. Recently VR technology has been shown to be a viable platform for medical simulation for the future.² Clinical Diabetes project leads therefore wondered if VR simulation may provide a means of offering junior doctors a safe training environment in the management of diabetes emergencies without any risk of harm to patients.

Summary of work

The DEVICE project uses Oculus Rift VR headsets in conjunction with Oxford Medical Simulation software in collaboration with Novo Nordisk which immerses learners in virtual scenarios. They are fully interactive, managing acutely unwell patients with diabetes (type 1 and type 2) as they would be in real life, giving the clinician the opportunity to diagnose and initiate treatment for the virtual patient and the ability to interact with the multiprofessional team. The environment, patient and other team members are fully interactive, with conversation and physiology adapting to user actions and treatment. Users then receive personalised feedback, performance metrics and a self-reflective debrief. This study looked at at how using the VR technology improves the confidence of the trainee clinician in managing diabetes emergencies and the retention of the knowledge over time to Kirkpatrick level 2. Junior Doctors and Advanced Clinical Practitioners had a 15-minute orientation and practice session on a test scenario and were then tested on the immersive DKA scenario.

Summary of results

This study demonstrated an improvement in the participants confidence in managing diabetes emergencies in the test scenario.

Discussion and conclusions

VR technology is a useful educational tool and increased the confidence of the participants in their ability to manage diabetes emergencies and their commitment to bringing back the knowledge gained to their daily practice. Positive feedback from participants included recommendation of VR as a useful modality for education in a safe environment.

Recommendations

This pilot study using VR method of education can be further developed in a larger study to compare VR education with standard classroom/workshop/in situ simulation with the same learning outcomes as the pilot study.

References

George JT, Warriner D, McGrane DJ, et al. Lack of confidence among trainee doctors in the management of diabetes: the Trainees Own Perception of Delivery of Care (TOPDOC) Diabetes Study. QJM. 2011;104(9):761–766. doi:10.1093/qjmed/hcr046 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3158855/ Harrington CM, et al., Development and evaluation of a trauma decision-making simulator in Oculus virtual reality. The American Journal of Surgery (2017), http://dx.doi.org/10.1016/j.amjsurg.2017.02.011