Effects of pre-training using serious game technology on CPR performance – an exploratory quasi-experimental transfer study

TLDR

Multiplayer virtual world technology enables medical procedure and team interaction practice via serious game software. The study investigates whether pre‑training with a multiplayer virtual world using avatars improves medical students’ CPR knowledge, skills, and proficiency. Three groups of 30 pre‑clinical medical students—two pre‑trained 6 or 18 months earlier with a multiplayer virtual world and a matched control with no pre‑training—were assessed before and after a high‑fidelity simulator session that began and ended with assessment scenarios and included three training scenarios, all video‑recorded for analysis. Students pre‑trained 6 months earlier showed significantly higher CPR knowledge, fewer guideline violations, and perfect chest‑compression pacing compared to the control, while the 18‑month group performed intermediate; these advantages diminished after training, supporting MVW‑CPR pre‑training as beneficial.

Abstract

Multiplayer virtual world (MVW) technology creates opportunities to practice medical procedures and team interactions using serious game software. This study aims to explore medical students' retention of knowledge and skills as well as their proficiency gain after pre-training using a MVW with avatars for cardio-pulmonary resuscitation (CPR) team training.Three groups of pre-clinical medical students, n = 30, were assessed and further trained using a high fidelity full-scale medical simulator: Two groups were pre-trained 6 and 18 months before assessment. A reference control group consisting of matched peers had no MVW pre-training. The groups consisted of 8, 12 and 10 subjects, respectively. The session started and ended with assessment scenarios, with 3 training scenarios in between. All scenarios were video-recorded for analysis of CPR performance.The 6 months group displayed greater CPR-related knowledge than the control group, 93 (±11)% compared to 65 (±28)% (p < 0.05), the 18 months group scored in between (73 (±23)%).At start the pre-trained groups adhered better to guidelines than the control group; mean violations 0.2 (±0.5), 1.5 (±1.0) and 4.5 (±1.0) for the 6 months, 18 months and control group respectively. Likewise, in the 6 months group no chest compression cycles were delivered at incorrect frequencies whereas 54 (±44)% in the control group (p < 0.05) and 44 (±49)% in 18 months group where incorrectly paced; differences that disappeared during training.This study supports the beneficial effects of MVW-CPR team training with avatars as a method for pre-training, or repetitive training, on CPR-skills among medical students.