Sharon L. Farra

Improved training for disasters using 3-D virtual reality simulation

The purpose of this study was to examine the effects of virtual reality simulation (VRS) on learning outcomes and retention of disaster training. The study used a longitudinal experimental design using two groups and repeated measures. A convenience sample of associate degree nursing students enrolled in a disaster course was randomized into two groups; both groups completed web-based modules; the treatment group also completed a virtually simulated disaster experience. Learning was measured using a 20-question multiple-choice knowledge assessment pre/post and at 2 months following training. Results were analyzed using the generalized linear model. Independent and paired t tests were used to examine the between- and within-participant differences. The main effect of the virtual simulation was strongly significant (p < .0001). The VRS effect demonstrated stability over time. In this preliminary examination, VRS is an instructional method that reinforces learning and improves learning retention.

Occupational and demographic factors associated with violence in the emergency department

Violence against health care workers is a serious and growing problem. The objectives of this cross-sectional study were to (a) describe the frequency of workplace violence (WPV) against emergency department (ED) workers; (b) identify demographic and occupational characteristics related to WPV; and (c) identify demographic and occupational characteristics related to feelings of safety and level of confidence when dealing with WPV. Survey data were collected from 213 workers at 6 hospital EDs. Verbal and physical violence was prevalent in all 6 EDs. There were no statistically significant differences in the frequency of violence for age, job title, patient population, and hospital location. Sexual harassment was the only category of violence affected by gender with females having a greater frequency. Feelings of safety were positively related to the frequency of WPV. Females were significantly more likely to feel unsafe and have less confidence in dealing with WPV. The study findings indicate that all ED workers are at risk of violence, regardless of personal and occupational characteristics. Feelings of safety are related to job satisfaction and turnover. Violence has serious consequences for the employers, employees, and patients. It is recommended that administration, managers, and employees collaborate to develop and implement prevention strategies to reduce and manage the violence.

Virtual reality disaster training: Translation to practice

Disaster training is crucial to the mitigation of both mortality and morbidity associated with disasters. Just as clinical practice needs to be grounded in evidence, effective disaster education is dependent upon the development and use of andragogic and pedagogic evidence. Educational research findings must be transformed into useable education strategies. Virtual reality simulation is a teaching methodology that has the potential to be a powerful educational tool. The purpose of this article is to translate research findings related to the use of virtual reality simulation in disaster training into education practice. The Ace Star Model serves as a valuable framework to translate the VRS teaching methodology and improve disaster training of healthcare professionals. Using the Ace Star Model as a framework to put evidence into practice, strategies for implementing a virtual reality simulation are addressed. Practice guidelines, implementation recommendations, integration to practice and evaluation are discussed. It is imperative that health educators provide more exemplars of how research evidence can be moved through the various stages of the model to advance practice and sustain learning outcomes.

A workplace violence educational program: A repeated measures study

Violence against healthcare employees is a profound problem in the emergency department worldwide. One strategy to reduce the risk of violence is prevention focused education. The purpose of this paper was to report the learning outcomes of a workplace violence educational prevention program tailored to the needs of emergency department employees. A quasi-experimental design was used to determine the knowledge retention of program content following a hybrid (online and classroom) educational intervention. One hundred twenty emergency department employees that completed the workplace violence prevention program participated in the study. A repeated-measures analysis of variance was conducted to determine if individual test scores increased significantly between baseline, posttest, and six month posttest periods. The results indicated a significant time effect, Wilks Λ = .390, F (2, 118) = 26.554, p < .001, η2 = .310. Follow-up polynomial contrasts indicated a significant linear effect with means increasing over time, F (1, 119) = 53.454, p < .001, η2 = .310, while individual test scores became significantly higher over time. It was concluded that the use of a hybrid modality increases the probability that significant learning outcomes and retention will be achieved.

Preparing Nursing Students for Leadership Using a Disaster-Related Simulation.

Increasing numbers and severity of disasters across the globe require nurses to be prepared to provide leadership in disaster situations. To address this need, a combination of didactic and simulation exercises was used to provide a daylong experience emphasizing application of nursing leadership skills in disasters to senior baccalaureate students. Evaluation of learning outcomes demonstrated significant improvement in student self-efficacy related to leadership in disasters.

Decontamination training: with and without virtual reality simulation.

Nurses must be prepared to care for patients following a disaster, including patients exposed to hazardous contaminants. The purpose of this study was to examine the use of virtual reality simulation (VRS) to teach the disaster-specific skill of decontamination. A quasi-experimental design was used to assign nursing students from 2 baccalaureate nursing programs to 1 of 2 groups to learn the disaster skill of decontamination—printed written directions or VRS. Performance, knowledge, and self-efficacy were outcome measures. Although students in the treatment group had significantly lower performance scores than the control group (p = 0.004), students taking part in VRS completed the skill in a significantly shorter amount of time (p = 0.008). No significant group differences were found for self-efficacy (p = 0.172) or knowledge (p = 0.631). However, students in the VRS treatment group reported high levels of satisfaction with VRS as a training method. The disaster-specific skill of decontamination is a low-volume, high-risk skill that must be performed with accuracy to protect both exposed patients and providers performing decontamination. As frontline providers for casualties following a disaster event, emergency nurses must be prepared to perform this skill when needed. Preparation requires cost-effective, timely, and evidence-based educational opportunities that promote positive outcomes. Further investigation is needed to determine the benefits and long-term effects of VRS for disaster education.

Effects of Virtual Reality Simulation on Worker Emergency Evacuation of Neonates

OBJECTIVE This study examined differences in learning outcomes among newborn intensive care unit (NICU) workers who underwent virtual reality simulation (VRS) emergency evacuation training versus those who received web-based clinical updates (CU). Learning outcomes included a) knowledge gained, b) confidence with evacuation, and c) performance in a live evacuation exercise. METHODS A longitudinal, mixed-method, quasi-experimental design was implemented utilizing a sample of NICU workers randomly assigned to VRS training or CUs. Four VRS scenarios were created that augmented neonate evacuation training materials. Learning was measured using cognitive assessments, self-efficacy questionnaire (baseline, 0, 4, 8, 12 months), and performance in a live drill (baseline, 12 months). Data were collected following training and analyzed using mixed model analysis. Focus groups captured VRS participant experiences. RESULTS The VRS and CU groups did not statistically differ based upon the scores on the Cognitive Assessment or perceived self-efficacy. The virtual reality group performance in the live exercise was statistically (P<.0001) and clinically (effect size of 1.71) better than that of the CU group. CONCLUSIONS Training using VRS is effective in promoting positive performance outcomes and should be included as a method for disaster training. VRS can allow an organization to train, test, and identify gaps in current emergency operation plans. In the unique case of disasters, which are low-volume and high-risk events, the participant can have access to an environment without endangering themselves or clients. (Disaster Med Public Health Preparedness. 2019;13:301-308).

Collaboration Between Academia and Practice: Interprofessional Crises Leadership and Disaster Management.

An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern childrens hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians. Included were simulated experiences at the National Center for Medical Readiness, a workshop, and online modules. The program that focused on crisis leadership and disaster management was developed and implemented to serve patient-centered organizations.

Learning and Retention Using Virtual Reality in a Decontamination Simulation.

AIMThe purpose of this study was to examine the longitudinal effects of virtual reality simulation (VRS) on learning outcomes and retention. BACKGROUNDDisaster preparation for health care professionals is seriously inadequate. VRS offers an opportunity to practice within a realistic and safe environment, but little is known about learning and retention using this pedagogy. METHODA quasiexperimental design was used to examine the use of VRS with baccalaureate nursing students in two different nursing programs in terms of the skill of decontamination. RESULTSResults indicate that VRS is at least as good as traditional methods and is superior in some cases for retention of knowledge and performance of skills. CONCLUSIONVRS may provide a valuable option for promoting skill development and retention. More research is needed to determine how to prepare nurses for skills that may not be required until months or even years after initial introduction.

National Disaster Health Consortium: Competency-Based Training and a Report on the American Nurses Credentialing Center Disaster Certification Development

As the largest profession of health care providers, nurses are an integral component of disaster response. Having clearly delineated competencies and developing training to acquire those competencies are needed to ensure nurses are ready when disasters occur. This article provides a review of nursing and interprofessional disaster competencies and development of a new interprofessional disaster certification. An overview of a standardized disaster training program, the National Disaster Health Consortium, is provided as an exemplar of a competency-based interprofessional disaster education program.