J Educ Eval Health Prof.  2020;17:1. 10.3352/jeehp.2020.17.1.

Effects of virtual reality training on decreasing the rates of needlestick or sharp injury in new-coming medical and nursing interns in Taiwan

• Wu SH
• Huang CC
• Huang SS
• Yang YY
• Liu CW
• Shulruf B
• Chen CH

• KMID: 2502187
• DOI: http://doi.org/10.3352/jeehp.2020.17.1

Abstract

Purpose
Senior nursing and medical interns’ lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needlestick or sharp injuries may harm themselves. Trainees’ self-reported needlestick or sharp injury rate was known to be especially high during the first 2 months of internship in Taiwan. This prospective cohort study aimed to assess the effect of newly developed virtual reality (VR) game, which uses Gagne’s learning model to improve universal precaution for needlestick or sharp injury prevention and decrease the rates of needle stick or sharp injuries in new-coming medical and nursing interns in Taiwan.
Methods
From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational needlestick or sharp injury prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors.
Results
In comparison with medical interns, a higher proportion of nursing interns had past experiences of deep occupational needlestick or sharp injury. Before VR training, the familiarity and confidence for needlestick or sharp injury prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep needlestick or sharp injury exhibited better performance on the accuracy rate and time needed to complete 20 decisions than those without past experiences in VR practice. All trainees showed an improved performance after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about needlestick or sharp injury prevention.
Conclusion
This self-developed VR game system using Gagne’s flow improved universal precaution for needlestick or sharp injury prevention and reduced the needlestick or sharp injury rates in the first 2 months of nursing and medical internship.

Keyword

Internship and residency; Needle stick injuries; Taiwan; Universal precautions; Virtual reality

Figure

• 

  Fig. 1. (A) The learning framework for new VR game-based training of UP for occupational NSI prevention. (B) Initial login page of the VR system, trainees chose safe or unsafe icon around the randomly appear 10 scenarios for either safe or unsafe behaviors. If the student make the wrong decision, App system will give comment wrong and provide correct answer. Conversely, the system will comment correct if the student makes correct decision. App subjectively evaluates and feedbacks performance of each student including accuracy rate and time need to complete 20 decisions, immediately. VR, virtual reality; UP, universal precaution; NSI, needlestick or sharp injuries.

• 

  Fig. 2. (A) Accuracy rate (%) of VR games between new nursing and medical interns. (B) ∆% of accuracy rate from first to second VR game-based practice. (C) Time to complete the VR game (sec). (D) ∆% of decrease in time need to complete 10 actions in second game compared to first VR game-based practice. VR, virtual reality. a)P<0.05 vs. nursing group. b)P<0.05 vs. first VR game-based practice.

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  Fig. 3. Comparison the mean and data distribution of accuracy rate (%) between nursing interns (A, B) or medical interns (C, D) with and without past experiences. VR, virtual reality; NSI, needlestick or sharp injuries. a)P<0.05 vs. counterparts without past occupational NSI experience. b)P<0.05 vs. first VR game-based practice.

• 

  Fig. 4. Comparison the mean and data distribution of the relative time to complete the VR game-based practice (/mean spent time of naive trainee in first VR game-based practice) between nursing interns (A, B) or medical interns (C, D) with and without past experiences. VR, virtual reality; NSI, needlestick or sharp injuries. a)P<0.05 vs. counterparts without past occupational NSI experience. b)P<0.05 vs. first VR game. c)P<0.05 vs. nursing interns.

Reference

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