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If you want to understand how behavior occurs, one of the best ways to gain information is to simply observe the behavior in its natural context. However, people might change their behavior in unexpected ways if they know they are being observed. How do researchers obtain accurate information when people tend to hide their natural behavior? As an example, imagine that your professor asks everyone in your class to raise their hand if they always wash their hands after using the restroom. Chances...
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Deconstructing Participant Behaviors in Virtual Reality Simulation: Ethnographic Analysis.

Daniel Loeb1,2, Jamie Shoemaker3, Kelly Ely1,3

  • 1Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, Cincinnati, OH, 45229, United States, 1 216-299-0004.

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Virtual reality (VR) simulation in medical education alters clinician attention and behavior, with participants prioritizing physical exams over monitors. Technical issues in VR can disrupt learning and immersion.

Keywords:
CPRVRVR-based simulationcardiopulmonary resuscitationchildrendevelopmentethnographic analysisethnographyimmersionpneumoniarespiratory distressresuscitationscenariossepsissimulationtooltrainingtraining methodvideo reviewvirtual reality

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Area of Science:

  • Medical Education
  • Virtual Reality Simulation
  • Healthcare Professional Training

Background:

  • Virtual reality (VR) simulation offers immersive 3D environments for medical education.
  • VR allows observation of subtle clinical findings like respiratory distress.
  • Impact of VR on participant behavior and attention remains understudied.

Purpose of the Study:

  • To describe clinician attention and decision-making during interprofessional pediatric resuscitation simulations in VR.
  • To analyze how the VR environment alters participant behavior and attention.
  • To reflect on the implications for VR simulation's educational value.

Main Methods:

  • Video-based focused ethnography used for data collection and analysis.
  • Expert analysis by critical care, resuscitation, simulation, and medical education specialists.
  • Scenarios analyzed until data saturation was achieved.

Main Results:

  • Participants prioritized physical examination over monitoring data.
  • VR imposed unique cognitive demands, increasing task burden.
  • Technical issues (e.g., navigation, interaction) caused "fidelity breakers," disrupting immersion and learning.

Conclusions:

  • VR may encourage a patient-centered examination approach.
  • Cognitive load in VR may mirror real-world clinical care.
  • Technical limitations and fidelity challenges must be addressed to align VR with learning objectives.