Assessing Simulation, Virtual Reality, and Television Modalities in Clinical Training

Background: High-fidelity simulation (sim) centers can accommodate large groups of observers through virtual reality (VR) observation. This study compared three learning modalities: active participation, VR observation, and television (TV) observation. Method: We used Immersive Tendencies and Presence questionnaires to measure subjective presence across modalities. Using a within-subjects AeBeA design, we measured 58 subjects three times during a three-part unfolding sim. An All-Sim track (sim -> sim -> sim) established baseline presence of sim participants. AeBeA tracks comprise VR tracks (VR -> TV -> VR), which were counterbalanced by TV tracks (TV -> VR -> TV). Results: A two-way analysis of covariance revealed significant effect of track across scenarios. All-sim presence was greatest, followed by VR, with TV being least. Conclusion: Findings suggest that VR observation mirrors active participation more closely than does TV observation. For further investigations, we proposed presence versus learning performance as well as VR observation for sim center collaborations. (C) 2018 International Nursing Association for Clinical Simulation and Learning. Published by Elsevier Inc. All rights reserved.