Original Investigation 

Medical Education

February 14, 2024

Effectiveness of Virtual Reality Training in Teaching Personal Protective Equipment Skills: A Randomized Clinical Trial

Keisuke Tsukada, Youichi Yasui, Satoshi Miyata, et al

JAMA Netw Open. 2024;7(2):e2355358. doi:10.1001/jamanetworkopen.2023.55358

Key Points

Question  Is virtual reality (VR) training effective in teaching donning and doffing of personal protective equipment (PPE) to prospective health care practitioners?

Findings  In this randomized noninferiority clinical trial of 91 students, VR and face-to-face training significantly outperformed and were superior to video training. Participants in the video group demonstrated significantly less accuracy in glove removal, hand hygiene, gown removal, and gown roll up.

Meaning  Findings of this study suggest that VR is a viable resource-conserving alternative approach to conventional training for PPE donning and doffing techniques.

Abstract

Importance  Training on the proper use of personal protective equipment (PPE) is critical for infection prevention among health care workers. Traditional methods, such as face-to-face and video-based training, can strain resources and present challenges.

Objective  To determine the effectiveness of 360° virtual reality (VR) training for PPE donning and doffing compared with face-to-face and video training in enhancing the PPE use skills of prospective health care practitioners.

Design, Setting, and Participants  A blinded, prospective, and randomized noninferiority clinical trial was conducted from August to December 2021 at Teikyo University School of Medicine in Tokyo, Japan, with a mixed population of medical students. Participants were second- to fourth-year medicine, medical technology, or pharmacy students aged 20 years or older with no prior PPE training. Participants were randomized into 1 of 3 training groups (VR, face-to-face, or video) based on their enrollment order. An intention-to-treat analysis was conducted.

Intervention  A 30-minute lecture on PPE procedures was delivered to all participants before the training. After the lecture, the VR group trained with an immersive 360° VR tool, the face-to-face group trained with actual PPE, and the video group trained by watching video footage on a computer and a projector. After 3 days, a standardized practical skills test was administered.

Main Outcomes and Measures  The primary outcome was the mean score on a 20-point practical skills test, and the secondary outcome was the percentage of correct execution.

Results  A total of 91 participants were recruited and randomized into 3 groups: VR (n = 30), face-to-face (n = 30), and video (n = 31) training. After excluding 1 participant due to illness, 90 participants (mean [SD] age, 24.2 [3.15] years; 54 males [60.0%]) completed the assessment. The mean (SD) scores were 17.70 (2.10) points for the VR group, 17.57 (2.45) points for the face-to-face group, and 15.87 (2.90) points for the video group. The VR group demonstrated no significant difference in performance from the face-to-face group. However, the VR group had significantly higher effectiveness than the video group (17.70 vs 15.87 points; P = .02).

Conclusions and Relevance  Results of this trial indicate that VR training was as effective as face-to-face training in enhancing PPE donning and doffing skills and was superior to video training. The findings suggest that VR training is a viable resource-conserving training option.

Trial Registration  Japan Registry of Clinical Trials Identifier: jRCT103021029