Using Virtual Reality to Assess Residents' Clinical Assessments During and After COVID-19.

Area of Science:

• Medical Education
• Pediatric Residency Training
• Simulation-Based Learning

Background:

• Pediatric hospitalizations for respiratory illnesses decreased during the COVID-19 pandemic, limiting trainee clinical exposure.
• Previous studies showed pediatric interns lacked skills in assessing and managing impending respiratory failure via virtual reality (VR) simulation.
• A limitation was the absence of performance data during periods of normal clinical volumes.

Purpose of the Study:

• To assess pediatric intern performance in a VR simulation of respiratory failure assessment.
• To compare intern performance during periods of normalized clinical volumes versus pandemic-related low volumes.

Main Methods:

• Cross-sectional observational study at an academic children's hospital.
• Three cohorts of pediatric interns completed a screen-based VR simulation.
• Performance was assessed via video review; Fischer's exact test analyzed statistical differences.

Main Results:

• 22, 11, and 24 interns participated in cohorts 1 (2021), 2 (2022), and 3 (2024).
• No statistical differences were found among cohorts in identifying altered mental status, impending respiratory failure, or need for escalation of care.

Conclusions:

• Intern performance in recognizing respiratory failure and escalation needs did not differ significantly across variable clinical volumes.
• Further investigation is required to understand how residents acquire critical clinical assessment skills.
• The role of VR in objectively assessing resident competency warrants further exploration.