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www.newcastle.edu.au

September 25, 2017

The School of Nursing and Midwifery | Faculty of Health and Medicine | The University of Newcastle

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Simulated Learning in Midwifery:

Exploring the use of virtual reality

technology in neonatal resuscitation

Presented by Associate Lecturer Jessica Williams

The University of Newcastle


Virtual Reality at the University of Newcastle

September 25, 2017


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Virtual Reality in the 21st Century

• No longer just attributed to futuristic, space-age technology

• VR and AR are receiving considerable attention – predicted to be worth

$162 billion by 2020

• Imbedded in 21st century culture – 3D

movies, interactive video games, AR

smart phone apps (Pokémon Go)

• Many conventions separate the user

from the experience via a screen

VR and AR headsets such as Oculus,

Gear VR, Google Cardboard, Hololens

are removing that ‘fourth wall’

• Developers now focused on ‘true immersion’

• Applications for this technology could be endless – health, education,

gaming, training

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Multi-modal learning: Where does virtual

reality fit in?

• Blended learning is widely used as a teaching method internationally

• Combinations of face to face learning with online/digital mediums

• Enhance the learning experiences of students and provide greater

flexibility in learning

• Recognises and caters to different

adult learning styles

• VR simulation may be a useful tool to

help bridge a gap between theory and

practice

• Research currently exists on VR

simulation for surgical training,

anatomical education/training, disaster training, emergency settings,

medication administration and transformative learning

• Very little VR research has been done in the field of midwifery September 25, 2017


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Neonatal Resuscitation: A Critical Skill for

Midwives

• How do we choose an appropriate learning area for virtual reality

teaching?

• Emergency skills training is valuable, due to difficulty gaining real-world

experiences

• Between 15-20% of newborn babies

require some form of resuscitation at

birth (ANZCOR, 2016; AIHW, 2016)

• Mandated in many Australian states as

a skill requiring annual competency

• Neonatal resuscitation app created by

the Innovations Team at UoN in

conjunction with midwifery academics to recreate a scenario

appropriate for the scope of practice of 2nd year midwifery students

• Trial run of app in Semester 1, 2017 complete

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Our Neonatal Resuscitation App

• Resuscitation begins with preparation

• Students must first prepare the resuscitation trolley with all required

equipment before the baby is born

• Critical thinking is required and

assessment of the baby takes place

(using APGAR scoring) on multiple

occasions

• Students progress through the scenario

as per ANZCOR resuscitation guidelines

• Calling for help – using ISBAR to

communicate with other professionals

• Progresses through a full scenario right down to neonatal CPR

• Recap at the end – communicating with partner and recalling events

• Guided and unguided modes to enhance learning September 25, 2017


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The Research

• Study population: 2nd year midwifery students

• Expected number of participants: Maximum of 39 in the 2018 cohort

and up to another 39 in the 2019 cohort

• Sampling method: Convenience

sampling

• Study design: Mixed methods

incorporating an RCT (control vs

intervention group) with qualitative

focus group interviews

• Data collection methods: Pre- and

post-surveys, psychological pre-

screening survey, biometric sensor

measurement of stress markers, focus groups. Also an ability to gather

analytics on the VR simulation app use.

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References

• Alotaibi, F. E., AlZhrani, G. A., Sabbagh, A. J., Azarnoush, H., Winkler-Schwartz, A., & Del Maestro, R. F.

(2015). Neurosurgical assessment of metrics including judgment and dexterity using the virtual reality

simulation NeuroTouch (NAJD Metrics). Surgical Innovation, 22(6), 636-642.

• Australian and New Zealand Council on Resuscitation (ANZCOR). (2016). ANZCOR guideline 13.1 –

Introduction to resuscitation of the newborn infant. Retrieved from https://resus.org.au/wpfb-file/anzcor-

guideline-13-1-aug16-pdf/

• Australian Institute of Health and Welfare (AIHW). (2016). National Perinatal Data Collection, 2014: Baby

outcomes. Retrieved from: http://www.aihw.gov.au/perinatal-data/source-data/

• Carolan-Rees, G., & Ray, A. F. (2015). The ScanTrainer obstetrics and gynaecology ultrasound virtual reality

training simulation: A cost model to determine the cost of viability of replacing clinical training with

simulation training. Ultrasound, 23(1), 110-115.

• Chang, T. P., & Weiner, D. (2016) Screen-based simulation and virtual reality for pediatric emergency medicine.

Clinical Pediatric Emergency Medicine, 17(3), 224-230.

• Eisert, S., & Geers, J. (2016). Pilot-study exploring time for simulation in academic and hospital-based

organizations. Clinical Simulation in Nursing, 12(1), 361-367.

• Farra, S. L., Miller, E. T., & Hodgson, E. (2015). Virtual reality disaster training: Translation to practice. Nurse

Education in Practice, 15, 53-57.

• Ferguson, C., Davidson, P. M., Scott, P. J., Jackson, D., & Hickman, L. D. (2015). Augmented reality, virtual

reality and gaming: An integral part of nursing. Contemporary Nurse, 51(1), 1-4.

• Fielding, K., Shapiro, R., & Tang, E. (2012). Responding to an emergency – How stress affects medical trainees.

University of Western Ontario Medical Journal, 81(1), 39-40.

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References continued

• Foronda, C., Budhathoki, C., & Salani, D. (2014). Use of multiuser, high-fidelity virtual simulation to teach

leadership styles to nursing students. Nurse Educator, 39(5), 209-211.

• International Data Corporation. (2017). Worldwide spending on augmented and virtual reality expected to double

or more every year through 2021, according to IDC. Retrieved from

http://www.idc.com/getdoc.jsp?containerId=prUS42959717

• Kleinheksel, A. J. (2014). Transformative learning through virtual patient simulations: Predicting critical student

reflections. Clinical Simulation in Nursing, 10(6), e301-e308.

• Lasater, K. (2007). High-fidelity simulation and the development of clinical judgment: Students’ experiences.

Journal of Nursing Education, 46(6), 269-276.

• Ludlow, B. L. (2015). Virtual reality: Emerging applications and future directions. Rural Special Education

Quarterly, 34(3), 3-10.

• Madrigal, E., Prajapati, S., & Hernandez-Prera, J. C. (2016). Introducing a virtual reality experience in anatomic

pathology education. American Journal of Clinical Pathology, 146(1), 462-468.

• Margolis, A. R., Porter, A. L., & Pitterle, M. E. (2017). Best practices for use of blended learning. American

Journal of Pharmaceutical Education, 81(3), 1-8.

• Nicely, S., & Farra, S. (2015). Fostering learning through interprofessional virtual reality simulation development.

Nursing Education Perspectives, 36(5), 335-336.

• NSW Health (2008). Clinical care and resuscitation of the newborn infant [Policy Directive]. Retrieved from

www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2008_027.pdf

• Rudd, C., Freeman, K., Swift, A., & Smith, P. (2010). Use of simulated learning environments in nursing curricula

[Report]. Western Australia: Health Workforce Australia.

September 25, 2017


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A presentation to the Australian Nurses and Midwives Conference 2017

21st September, 2017


ANY QUESTIONS?
